Hashmi Atif Ali, Malik Babar, Edhi Muhammad Muzzammil, Faridi Naveen, Ashraful Muhammad
Dhaka medical college, Dhaka, Bangladesh.
Int Arch Med. 2014 Jan 16;7(1):5. doi: 10.1186/1755-7682-7-5.
Lipoma is a benign soft tissue neoplasm that may contain mesenchymal elements, as a result of metaplastic process. Ossification in benign and malignant soft tissue tumors can also manifest due to metaplastic process.
A 45 year old woman presented with a large thigh mass. The mass was developed one and a half year ago which insidiously increased in size and was associated with movement restriction. Radiological findings revealed soft tissue neoplasm on antero-medial aspect of thigh encircling the femur and displacing adjacent muscles. Fine trabeculations were seen in neoplasm suggestive of ossification. Excision of the mass was performed and histopathology revealed adipocytes with mature bony trabeculae possessing prominent osteoblastic rimming suggestive of ossifying lipoma.
It is important to recognize this variant of lipoma as it is associated with a better clinical outcome in contrast to most of the deep seated soft tissue neoplasms. Secondly it should also be differentiated from myositis ossificans and heterologous differentiation in other soft tissue neoplasms. We suggest an algorithmic approach to the diagnosis of ossifying soft tissue neoplasms histopathologically. Mature bony trabeculae with prominent osteoblastic rimming in a soft tissue lesion are due to a metaplastic process and should not be confused with osteosarcoma.
脂肪瘤是一种良性软组织肿瘤，由于化生过程，可能含有间充质成分。良性和恶性软组织肿瘤中的骨化也可因化生过程而表现出来。
一名45岁女性因大腿出现巨大肿块就诊。该肿块于一年半前出现，大小隐匿性增大，并伴有活动受限。影像学检查结果显示大腿前内侧有软组织肿瘤，包绕股骨并推移相邻肌肉。肿瘤内可见细小梁，提示骨化。对肿块进行了切除，组织病理学显示脂肪细胞与成熟的骨小梁并存，骨小梁周围有明显的成骨细胞包绕，提示为骨化性脂肪瘤。
认识这种脂肪瘤变体很重要，因为与大多数深部软组织肿瘤相比，它具有更好的临床预后。其次，它也应与骨化性肌炎以及其他软组织肿瘤中的异源性分化相鉴别。我们建议采用一种算法方法对骨化性软组织肿瘤进行组织病理学诊断。软组织病变中具有明显成骨细胞包绕的成熟骨小梁是化生过程所致，不应与骨肉瘤相混淆。
