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胫骨骨内脂肪瘤的临床、放射学及病理学研究:一例报告

Clinical, radiologic, and pathologic study of intraosseous lipoma of the tibia: A case report.

作者信息

Liu Peng, Zhang Kai, Zeng Jian-Kang, Chang Yan-Feng, Zhuang Kai-Peng, Zhou Sheng-Hu

机构信息

Department of Joint Surgery, The 940 Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou 730050, Gansu Province, China.

出版信息

World J Clin Cases. 2025 May 16;13(14):101950. doi: 10.12998/wjcc.v13.i14.101950.

Abstract

BACKGROUND

Intraosseous lipoma of bone is one of the rarest benign bone tumors, which often involves the metaphysis of long tubular bones, especially the femur, tibia, fibula, and calcaneus. Bone lipoma can be characterized by chronic dull pain but can also be asymptomatic most of the time. As a result, it is less likely to attract people's attention and is occasionally diagnosed through imaging examination during routine physical health check-up.

CASE SUMMARY

We describe a clinical case of intraosseous lipoma in a 21-year-old patient with chronic pain in the left lower limb for four years without any significant physical findings apart from the minimal swelling and local tenderness over the median ankle. Computerized tomography suggested the possibility of a lipoma on the left distal tibia, but the pathological examination could make a definite diagnosis. The intraosseous lipoma of the left distal tibia was treated by surgical curettage, bone graft, and internal fixation with steel plate, since the conservative treatment is often ineffective. Postoperatively, the patient made an uneventful recovery and was able to do daily activities without any restrictions. In addition, local recurrence of the intraosseous lipoma was not reported in subsequent reexamination.

CONCLUSION

Bone lipoma is very rare and often exhibits no characteristic clinical manifestation. The confirmative diagnosis of lipoma largely relies on a combination of imageology and biopsy. Surgical intervention is often recommended as a conventional therapy for bone lipoma. Postoperatively, the patient makes an uneventful recovery with a good prognosis, and the local recurrence of the tumor is also a low probability event.

摘要

背景

骨内脂肪瘤是最罕见的良性骨肿瘤之一,常累及长管状骨的干骺端,尤其是股骨、胫骨、腓骨和跟骨。骨脂肪瘤的特点可能是慢性钝痛,但多数情况下也可无症状。因此,它不太容易引起人们的注意,偶尔在常规健康体检的影像学检查中被诊断出来。

病例摘要

我们描述了一例21岁患者的骨内脂肪瘤临床病例,该患者左下肢慢性疼痛4年,除踝关节中部轻微肿胀和局部压痛外,无任何明显体征。计算机断层扫描提示左胫骨远端可能存在脂肪瘤,但病理检查才能做出明确诊断。由于保守治疗往往无效,左胫骨远端骨内脂肪瘤采用手术刮除、植骨及钢板内固定治疗。术后,患者恢复顺利,能够不受限制地进行日常活动。此外,后续复查未报告骨内脂肪瘤局部复发情况。

结论

骨脂肪瘤非常罕见,通常无特征性临床表现。脂肪瘤的确诊很大程度上依赖于影像学和活检相结合。手术干预常被推荐为骨脂肪瘤的常规治疗方法。术后,患者恢复顺利,预后良好,肿瘤局部复发也是低概率事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d5/11752428/da4b1deaaeb9/101950-g001.jpg

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