Intraosseous lipoma

Abstract

Intraosseous lipoma, which is cansidered to be the rarest of the primary benign bone tumaus, is mostly localized in long tubular bones. Our case was a 35 years old male patient with the complaint of pain which was disturbing him while bending forward with the knees extended. During the physical examination, a 2x2 cm mass has been palpated at the lateral side of the left knee, the proximal end of fibula. It was locally tender. The lesion was found, by the direct x-ray films, to be in the left fibular proximal metaphyseo-diaphyseal region. Being intramedullary it had vague borderlines and by locally expanding, caused the lateral cortex get thinner. It appeared as an osteolytic lesion having more radiolucent, patchy areas. CT scans have revealec expansion in the metaphyseodiaphyseal region, cortical thinness, medullary expansion in the left proximal fibula. Because of the localisation, it has been decided to resect the proximal 1/3 of the fibula. Microscopic findings reveded that the lesion consisted of mature adipose tissue having thin trabecules of bone in between, with no atypical cells and necrosis. Absence of necrosis, calcification or reactive systemic changes has led to evaluation of the lesion as stage 1. Since the lesion does rot show any tendenay toward malignant deqeneration and metastases, its treatment should be conservative. However it has been suggested to perform curettage with or without using bone grafts. No recurrance has yet been reported.

Özet

İntraossöz lipom kemiğin en nadir görülen benign tümörü olarak kabul edilen bir lezyondur. Sıklıkla uzun kemiklerde yerleşir. Olgumuz ağrı şikayetiyle başvuran 35 yaşında erkek hasta olup, sol fibula proksimal metafizodiafizer bölgede intraossöz lipom saptanmıştır.