OJMI  Vol.2 No.2 , June 2012
Intraosseous Lipoma with Subsequent Esophageal Carcinoma Metastasis
Abstract: Background: This case report describes a well documented proximal femoral metadiaphysis intraosseous lipoma which later developed metastasis from a new esophageal cancer. Metastatic disease to benign conditions is a rare finding. To the best of our knowledge, this is the first reported case of metastatic disease to an intraosseous lipoma. Case Description: The metastatic deposit was initially detected by plain-film radiography, performed to evaluate new onset right hip pain, as possible new cortical breakthrough with irregularity in the site of previously known proximal right femur intraosseous lipoma. Concurrent follow-up PET/CT study showed a new hypermetabolic focus within the known intraosseous lipoma indicating a new metastasis that was confirmed with an MRI as a new enhancing mass within the preexisting intraosseous lipoma. Subsequently, an MRI-guided biopsy and eventually surgical excision was performed providing the histological samples for radiologic-pathologic correlation. Purpose and Clinical Relevance: Clinicians need to be aware that unusual, complex patterns within benign lesions may be a reflection of unexpected conditions, such as insufficiency injury, malignant transformation and secondary metastatic disease, as exemplified by our case report.
Cite this paper: nullS. Ramandeep, M. John, R. Priya, B. Gregg, C. Czerniak and L. Patrick, "Intraosseous Lipoma with Subsequent Esophageal Carcinoma Metastasis," Open Journal of Medical Imaging, Vol. 2 No. 2, 2012, pp. 64-67. doi: 10.4236/ojmi.2012.22011.

[1]   M. F. Blacksin, N. Ende and J. Benevenia, “Magnetic Resonance Imaging of Intraosseous Lipomas: A RadiologicPathologic Correlation,” Skeletal Radiology, Vol. 24, No. 1, 1995, pp. 37-41. doi:10.1007/BF02425945

[2]   R. S. D. Campbell, A. J. Grainger, D. C. Mangham, I. Beggs, J. Teh and A. M. Davies, “Intraosseous Lipoma: Report of 35 New Cases and a Review of the Literature,” Skeletal Radiology, Vol. 32, No. 4, 2003, pp. 209-222. doi:10.1007/s00256-002-0616-7

[3]   J. Cuomo, F. H. Warren, L. M. Sanders and D. J. Beech, “Solitary Scapula Mass: Atypical Presentation of Esophageal Adenocarcinoma,” American Surgeon, Vol. 64, No. 5, 1998, pp. 466-470.

[4]   J. W. Milgram, “Malignant Transformation in Bone Lipomas,” Skeletal Radiology, Vol. 19, No. 5, 1990, pp. 347352. doi:10.1007/BF00193088

[5]   M. D. Murphey, J. F. Carroll, D. J. Flemming, T. L. Pope, F. H. Gannon and M. J. Kransdorf, “From the Archives of the AFIP: Benign Musculoskeletal Lipomatous Lesions,” Radiographics, Vol. 24, No. 5, 2004, pp. 1433-1466. doi:10.1148/rg.245045120

[6]   H. Ozdemir, Z. Bozgeyik, E. Kocakoc and O. Kalender, “MRI Findings of Intraosseous Lipoma: Case Report,” Magnetic Resonance Imaging, Vol. 22, No. 2, 2004, pp. 281-284. doi:10.1016/j.mri.2003.08.032

[7]   T. Propeck, M. A. Bullard, J. Lin, K. Doi and W. Martel, “Radiologic-Pathologic Correlation of Intraosseous Lipomas,” American Journal of Roentgenology, Vol. 175, No. 3, 2000, pp. 673-678.

[8]   L. E. Quint, L. M. Hepburn, I. R. Francis, R. I. Whyte and M. B. Orringer, “Incidence and Distribution of Distant Metastases from Newly Diagnosed Esophageal Carcinoma,” Cancer, Vol. 76, No. 7, 1995, pp. 1120-1125. doi:10.1002/1097-0142(19951001)76:7<1120::AID-CNCR2820760704>3.0.CO;2-W

[9]   D. C. Dahlin and K. K. Unni, “General Aspects and Data on 11087 Cases,” 5th Edition, Lipponcott-Raven, Philadelphia, 1996.

[10]   M. Yildirim, A. Say?n, F. Oztop, B. Doganavsargil and E. Goker, “Collision Tumor of the Scapula: A Case Report,” The Internet Journal of Surgery, Vol. 17, No. 2, 2008.

[11]   J. T. Goodner and A. D. Turnbull, “Bone Metastases in Cancer of the Esophagus,” American Journal of Roentgenology, Vol. 111, No. 2, 1971, pp. 365-367.

[12]   A. Kapukaya, M. Subasi, N. Dabak and E. Ozkul, “Osseous Lipoma: Eleven New Cases and Review of the Literature,” Acta Orthopaedica Belgica, Vol. 72, No. 5, 2006, pp. 603-614.

[13]   J. W. Milgram, “Intraosseous lipomas: A Clinicopathologic Study of 66 Cases,” Clinical Orthopaedics & Related Research, Vol. 231, 1988, pp. 277-302.