Parosteal lipoma of the femur with hyperostosis: case report and literature review

A 55-year-old female patient noticed an increase in thevolume of her left thigh, without associated pain, approxi-mately 8 years ago. She reported a related local trauma af-ter a ground-level fall at the time. In 2003 she was admit-ted to our Service, and the clinical evaluation revealed anonpulsatile mass in the anteromedial face of the distal two-thirds of the left thigh that had a tender consistency andregular contour adhered to the deep planes and that waspainless upon diffuse palpation.Conventional radiographs of the left thigh showed thepresence of a spiculated periosteal bone formation in theanteromedial face of the distal region of the femur and anincrease in the amount of soft tissue with a radiodensitycharacteristic of fatty tissue (radiolucent image) (Figure 1).Computed tomography of the left thigh showed a het-erogeneous calcification image in the periosteal topogra-phy located in the medial region of the distal third of thefemur in the metadiaphyseal junction, without rupture ofthe cortical or bone marrow invasion. In the muscular plane,the density was similar to that of subcutaneous tissue inthe intermediate vastus muscle topography, suggesting fatreplacement (Figure 2).After the evaluations were completed, only in January2005 did the patient return to the outpatient facility with asmall increase in the size of the tumor.