Intraosseous Lipoma with Subsequent Esophageal Carcinoma Metastasis

Singh Ramandeep, Madewell John, Rao Priya, Bean Gregg, Czerniak Czerniak, Lin Patrick

Department of Musculoskeletal Radiology, University of Texas MD Anderson Cancer Center, Houston, USA.
Department of Orthopedic Oncology, University of Texas MD Anderson Cancer Center, Houston, USA.
Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, USA.

DOI: 10.4236/ojmi.2012.22011                

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.

Keywords

Intraosseous Lipoma; Esophageal Cancer; MRI; PET/CT; Metastasis

Conflicts of Interest

The authors declare no conflicts of interest.

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