Treatment of Huge Intraosseous Lipoma of Distal Femur with Genu Valgum: A Case Report

Shih-Kai Cho, F. Lee, Matthew N H Wang, Nai-Phon Wang
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Abstract

Intraosseous lipomas are rare benign primary tumors of the bone. The intraosseous lipoma may be asymptomatic, and then the lesion may be found incidentally during radiological investigation following an injury in the same region. Intraosseous lipoma is frequently confused histologically or radiologically with fibrous dysplasia, enchondroma, osteoblastoma, chondrosarcoma, bone cyst, and bone infarct. We report a 64-year-old woman suffered from exacerbation of climbing-stairs pain in her right knee due to a juxta-articular bone tumor in distal femur. The symptoms improved after excisional curettage of the tumor and then reconstructed with constrained condylar knee replacement. Histopathological examination of the tumor confirmed the diagnosis of intraosseous lipoma. Although intraosseous lipomas are considered benign lesions and are treated conservatively due to their propensity for spontaneous involution, curettage and grafting has been suggested in cases with painful tumors, pathological fractures or other secondary changes. Curettage and bone grafting is an option for treatment with a good clinical and functional result. And intraosseous lipoma should be considered in the differential diagnosis of osteoblastic lesions for the orthopedic surgeon.
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膝外翻治疗股骨远端巨大骨内脂肪瘤1例
骨内脂肪瘤是一种罕见的骨内良性肿瘤。骨内脂肪瘤可能是无症状的,然后在同一区域受伤后的放射检查中偶然发现病变。骨内脂肪瘤在组织学或影像学上常与纤维发育不良、内生纤维瘤、成骨细胞瘤、软骨肉瘤、骨囊肿和骨梗死相混淆。我们报告了一位64岁的女性,由于股骨远端关节旁的骨肿瘤,导致右膝爬楼梯疼痛加剧。切除肿瘤后症状得到改善,然后用约束髁膝关节置换术重建。肿瘤的组织病理学检查证实骨内脂肪瘤的诊断。尽管骨内脂肪瘤被认为是良性病变,并且由于其自发复发的倾向而采取保守治疗,但对于出现疼痛性肿瘤、病理性骨折或其他继发病变的病例,建议进行刮除和移植。刮除和植骨是一种治疗的选择,具有良好的临床和功能结果。骨内脂肪瘤是骨科医生鉴别诊断成骨细胞病变时应考虑的因素。
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