CASE REPORTS   

Chirurgia 2011 April;24(2):107-10

Copyright © 2011 EDIZIONI MINERVA MEDICA

language: English

A big parosteal lipoma of the thigh

Pompili G., Tarico M. S., Scrimali L., Scilletta A., Tamburino S., Curreri S. W., Soma P. F., Perotta R.

Department of Plastic Surgery, University of Catania/Cannizzaro Hospital, Catania, Italy

Lipomas are the most common soft tissue lesions, but are among the rarest neoplasias of the skeleton, accounting for less than 0.1% of primary bone tumours. Parosteal type is a rare tumour, accounting for 0.3% of all lipomas. The most common anatomic locations of parosteal lipoma are the diaphysis and metaphysis of long bones, such as the proximal part of the radius, the femur, the tibia and the humerus, but the overall anatomic distribution is very wide. Parosteal lipoma is an uncommon benign neoplasm of mature adipose tissue contiguous with underlying periosteal bone. It affects almost exclusively adults over 40, of either sex. The prognosis is excellent with no proven reports of malignancy and rarely recurrence. This study reports the case of an old man (72 years) with a very big mass in the anterior part of the right thigh. He complained sensivity-loss, easy fatigue while walking, weakness while standing with no history of trauma and no systemic signs. MR revealed a parosteal lipoma with a wide osseous anchoring, measuring 29.5 × 11.6 × 8.5 cm, involving the entire vastus muscle. The patient underwent surgery in spinal anesthesia, incising along the lateral border of the sartorius muscle, divaricating the residual fibers of vastus muscle and exposing tumour. This one was excised undocking the periosteal’s attachment. The lipoma weighted 1 300 g. Patient’s fatigue and weakness immediately disappeared, while hypoesthesia resolved three months after surgery. Patient returned to full activity with no further adjuvant treatment and his conditions are still good.