Introduction:
Benign fibroosseous lesion, complex mixture of lipoma, fibroxanthoma, myxoma, myxofibroma, fibrous dysplasia–like features, cyst formation, fat necrosis, ischemic ossification, rarely cartilage
Often discovered incidentally (40%), nonspecific pain (50%), pathologic fracture (10%)
Most commonly affects intertrochanteric region of femur (85% )
Radiograph:
Relatively characteristic radiologic appearance and skeletal distribution; typically shows geographic lytic lesion with well-defined sclerotic margin; Bone may be slightly expansile; mineralization may be seen
Bone scintigraphy:
Increased activity, not as intense as in FD
CT or MR:
Intermixture of fat
Differentials:
Intraosseous lipoma, fibrous dysplasia
Treatment:
Asymptomatics may not need treatment
Curettage, bone grafting, fixation
Increased prevalence of malignant transformation
References:
Murphey MD et al. Benign Musculoskeletal Lipomatous Lesions. RadioGraphics 2004;24:1433-1466
