Age / Sex : 64 / M

Chief complaint: left thigh pain (bladder cancer history)

1) What is your impression?

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

(Quiz는 quiz일 뿐이오니 답안은 한개만 보내주시기 바라오며, 복수의 답안을 보내주시는 분은 정답이 포함되어 있더라도 부득이 semi-correct answer로 처리토록 하겠습니다.)

Courtesy: 하동호(Dong-Ho, Ha), 동아대병원(Dong-A University Hospital)

Liposclerosing Myxofibrous Tumor

Discussion

Findings:

well defined
geographic radiolucent lesion with sclerotic rim at the intertrochanteric area
of the femur 

Differential Diagnosis:

Liposclerosing
Myxofibrous Tumor

Fibrous
dysplasia

Intraosseous
lipoma

Diagnosis: Liposclerosing Myxofibrous Tumor

Discussion:

Benign
fibro-osseous lesions involving the intertrochanteric region of the femur

Characterized
by a complex mixture of histologic elements that may include lipoma,
fibroxanthoma, myxoma, myxofibroma, fibrous dysplasia-like features, cyst
formation, fat necrosis, ischemic ossification, and, rarely, cartilage

Age : 2nd ~
7th decades of life, mean age about 40 years, M=F

Location :
proximal portion of the femur (80 – 85%)

         (intertrochanteric lesion, 91%)   

Radiographic
findings

   geographic lytic lesion

   well-defined and often sclerotic margin,
internal mineralization

   mild expansion of the bone

Malignant
transformation has been noted in 10% of cases, MFH or osteosarcoma

   areas of focal bone destruction and
associated soft tissue mass

References:

1.     Radiology 1999;212:693-698

2.     Bone and Joint Imaging, 3rd ed,
Resnick, Krandorf

3.     Magnetic Resonance Imaging in
Orthopaedics and Sports Medicine, 3rd ed, Stoller