OBJECTIVE: The purpose of this report is to present the case of a 54-year-old female patient with a pathologically confirmed diagnosis of soft tissue lipoma. The clinical presentation, pathophysiology, differential diagnosis, and treatment options for lipoma are described. CLINICAL FEATURES: The patient presented to a chiropractic clinic with painful swelling in the right anterior thigh. Physical examination revealed a palpable mobile mass with minimal tenderness. INTERVENTION AND OUTCOME: The initial consultation was with the primary care physician, and it resulted in a sonographic examination as the initial imaging modality to rule out deep venous thrombosis. The result of this examination was negative. Following a delay by additional incorrect diagnoses and treatments, a diagnosis of an intermuscular lipoma was established by magnetic resonance imaging and confirmed on biopsy as a soft tissue lipoma. The patient underwent complete excision of the mass. CONCLUSION: Lipomas are common benign soft tissue masses and should be considered in the differential diagnosis of a thigh mass. Magnetic resonance imaging with contrast depicts the lipomatous mass as having a characteristic high-intensity fat signal without enhancement. It is important for clinicians to have an increased awareness in recognizing the clinical and imaging manifestations of a soft tissue lipoma to optimize an initial diagnosis and treatment.
OBJECTIVE: The purpose of this report is to present the case of a 54-year-old female patient with a pathologically confirmed diagnosis of soft tissue lipoma. The clinical presentation, pathophysiology, differential diagnosis, and treatment options for lipoma are described. CLINICAL FEATURES: The patient presented to a chiropractic clinic with painful swelling in the right anterior thigh. Physical examination revealed a palpable mobile mass with minimal tenderness. INTERVENTION AND OUTCOME: The initial consultation was with the primary care physician, and it resulted in a sonographic examination as the initial imaging modality to rule out deep venous thrombosis. The result of this examination was negative. Following a delay by additional incorrect diagnoses and treatments, a diagnosis of an intermuscular lipoma was established by magnetic resonance imaging and confirmed on biopsy as a soft tissue lipoma. The patient underwent complete excision of the mass. CONCLUSION:Lipomas are common benign soft tissue masses and should be considered in the differential diagnosis of a thigh mass. Magnetic resonance imaging with contrast depicts the lipomatous mass as having a characteristic high-intensity fat signal without enhancement. It is important for clinicians to have an increased awareness in recognizing the clinical and imaging manifestations of a soft tissue lipoma to optimize an initial diagnosis and treatment.
Authors: P L Munk; M J Lee; D L Janzen; D G Connell; P M Logan; P Y Poon; T C Bainbridge Journal: AJR Am J Roentgenol Date: 1997-08 Impact factor: 3.959
Authors: Prasuna Inampudi; Jon A Jacobson; David P Fessell; Ruth C Carlos; Smita V Patel; Lydia O Delaney-Sathy; Marnix T van Holsbeeck Journal: Radiology Date: 2004-10-14 Impact factor: 11.105
Authors: Giuseppe Nigri; Mario Dente; Stefano Valabrega; Giacomo Beccaria; Paolo Aurello; Francesco D'Angelo; Francesco Di Marzo; Giovanni Ramacciato Journal: J Med Case Rep Date: 2008-09-30