Kaeser Martha A, Smith Linda W, Kettner Norman W
Resident, Department of Radiology, Logan College of Chiropractic, Chesterfield, MO 63006-1065.
J Chiropr Med. 2010 Sep;9(3):127-31. doi: 10.1016/j.jcm.2010.03.004.
The purpose of this report is to present the case of a 54-year-old female patient with a pathologically confirmed diagnosis of soft tissue lipoma. The clinical presentation, pathophysiology, differential diagnosis, and treatment options for lipoma are described.
The patient presented to a chiropractic clinic with painful swelling in the right anterior thigh. Physical examination revealed a palpable mobile mass with minimal tenderness.
The initial consultation was with the primary care physician, and it resulted in a sonographic examination as the initial imaging modality to rule out deep venous thrombosis. The result of this examination was negative. Following a delay by additional incorrect diagnoses and treatments, a diagnosis of an intermuscular lipoma was established by magnetic resonance imaging and confirmed on biopsy as a soft tissue lipoma. The patient underwent complete excision of the mass.
Lipomas are common benign soft tissue masses and should be considered in the differential diagnosis of a thigh mass. Magnetic resonance imaging with contrast depicts the lipomatous mass as having a characteristic high-intensity fat signal without enhancement. It is important for clinicians to have an increased awareness in recognizing the clinical and imaging manifestations of a soft tissue lipoma to optimize an initial diagnosis and treatment.
本报告旨在介绍一名54岁女性患者，其病理确诊为软组织脂肪瘤。描述了脂肪瘤的临床表现、病理生理学、鉴别诊断及治疗选择。
该患者因右大腿前侧疼痛肿胀就诊于一家整脊诊所。体格检查发现可触及一个活动的肿块，压痛轻微。
最初由初级保健医生进行会诊，随后进行了超声检查作为初步成像方式以排除深静脉血栓形成。该检查结果为阴性。在经历了因其他错误诊断和治疗导致的延误后，通过磁共振成像确诊为肌间脂肪瘤，并经活检证实为软组织脂肪瘤。患者接受了肿块的完整切除。
脂肪瘤是常见的良性软组织肿块，在大腿肿块的鉴别诊断中应予以考虑。增强磁共振成像显示脂肪瘤肿块具有特征性的高强度脂肪信号且无强化。临床医生提高对软组织脂肪瘤临床和影像学表现的认识，对于优化初始诊断和治疗非常重要。
