Age / Sex : 48 / M

Chief complaint: Incidental finding

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Two weeks later, you can see the final diagnosis with a brief discussion of this case.

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Courtesy: Soojung Choi, University of Ulsan, Gangneung Asan Hospital

Liposclerosing myxofibrous tumor

Discussion

Findings: Geographic osteolytic lesion with sclerotic rim in intertrochanteric region of left proximal femur. Internal contents are mixed nature with mineralization inside the mass.

Differential Diagnosis: liposclerosing myxofibrous tumor

                      Aneurysmal bone cyst

                      Cystic fibrous dysplasia

Diagnosis: liposclerosing myxofibrous tumor

Discussion:

This tumour comprises of the wide mixture of lipomatous, fibroxanthomatous, myxomatous, and myxofibromatous components. The location of this tumor has a striking predilection for the intertrochanteric region of the femur (80-90%).

Radiographic features

Plain film and CT scan

•  geographic lytic lesion in intertrochanteric region of proximal femur


•  sclerotic margin


•  mildly expansile 


•  matrix calcification in ~70% of cases


•  fat density component 

MRI

Despite its name distinct fatty components are not seen

• T1: relatively homogeneous and isointense to skeletal muscle


• T2: moderately heterogeneous and high signal 

References:

1.     Radiopaedia.org. http://radiopaedia.org/articles/liposclerosing-myxofibrous-tumour

2.     Murphey MD, Carroll JF, Flemming DJ et-al. From the archives of the AFIP: benign musculoskeletal lipomatous lesions. Radiographics. 2004; 24 (5): 1433-66.