Goto Takahiro, Kojima Tatsuyoshi, Iijima Takuo, Yokokura Satoshi, Motoi Toru, Kawano Hirotaka, Yamamoto Aiichiro, Matsuda Koichi
Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
J Orthop Sci. 2002;7(2):274-80. doi: 10.1007/s007760200046.
We studied 12 patients (13 bones) with intraosseous lipoma to elucidate the clinical features of this disease. The patients ranged in age from 14 to 54 years. Eleven patients were men and 1 was a woman. The involved bones were the calcaneus in 6 patients (7 bones), humerus in 3, ischium in 2, and sacrum in 1. Three bones were in Milgram's stage I, 8 were in stage II, and 2 were in stage III. On plain radiographs, all bones showed a well-circumscribed radiolucent area. Nine bones showed calcification or ossification. Computed tomography or magnetic resonance imaging showed low density or high signal intensity, respectively, identical to the findings in normal adipose tissue. The tumor was curetted in 3 patients (3 bones), in whom local recurrence was not seen thereafter. In the remaining 9 patients (10 bones), we observed the natural course; in 1 of these patients, incisional biopsy was performed. During the follow-up period, only 1 patient showed slight enlargement of the lesion, while the findings in the others remained unchanged. Three patients had pain, which disappeared after the surgery or during the course of the observation. Partly because intraosseous lipoma tends to undergo spontaneous involution, and partly because diagnosis is easy from the radiological findings, surgery does not seem to be necessary in most patients.
我们研究了12例（13块骨）骨内脂肪瘤患者，以阐明该疾病的临床特征。患者年龄在14至54岁之间。11例为男性，1例为女性。受累骨骼中，跟骨6例（7块骨），肱骨3例，坐骨2例，骶骨1例。3块骨处于米尔格拉姆I期，8块处于II期，2块处于III期。在X线平片上，所有骨骼均显示边界清晰的透光区。9块骨显示有钙化或骨化。计算机断层扫描或磁共振成像分别显示低密度或高信号强度，与正常脂肪组织的表现相同。3例患者（3块骨）行刮除术，术后未见局部复发。其余9例患者（10块骨），我们观察其自然病程；其中1例患者行切开活检。在随访期间，只有1例患者病变略有增大，其他患者的表现保持不变。3例患者有疼痛，术后或观察过程中疼痛消失。部分原因是骨内脂肪瘤倾向于自发消退，部分原因是根据影像学表现易于诊断，大多数患者似乎无需手术。
