Intraosseous lipoma of the tibia
Keywords:
intraosseous lipoma, rare, radiological diagnostic, need clinical pahological conferenceAbstract
Introduction:
Intraosseous lipoma is a rare benign bone tumor originating from proliferative mature lipocytes. The incidence of intraosseous lipoma is considered to be less than 0.1 % of all primary bone tumors. In recent years, an increasing number of cases of this disease have been reported, and the real incidence of the disease seems higher than the previously recognized. With the advancement of computed tomography (CT) and magnetic resonance imaging (MRI), the identification of intralesional fat is enabled, as well as dystrophic calcification and cyst formation.
Methods:
We report one case of patient with intraosseous lipoma of tibia diagnosed by biopsy from curettage of the lesion. The patient underwent curettage, bone graft and internal fixation with plate and screws. Histological examination of the specimen revealed a chronic osteomyelitis with no marked anomalies. The patient was discussed in the Clinical Pathological Conference (CPC).
Results:
Initially, from the CPC, the patient was diagnosed with chronic osteomyelitis of the left tibia. The histological examination was then re-reviewed by performing deep section of the preparation and the result was lipoma of the bone. One year after the surgery, the oncologic outcome was evaluated, there were no local recurrence or infection detected. The orthopaedic outcomes showed that the graft had been united, but the plate was still needed to be retained and the screw needed to be fixed because the patient decided to remove the implant when she had her ligament operated. The functional outcomes showed that the patient could walk and had full range of motion.
Conclusion:
Intraosseous lipoma is a rare benign bone lesion that is difficult to diagnose with plain film imaging alone. However, CT and MRI can reveal intraosseous lipoma accurately. In spite of this, the diagnosis of intraosseous lipoma still need to be confirmed by the collaboration of orthopaedics, radiologist and pathologist in a clinical pathological conference.
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