A case report of an intermuscular lipoma: presentation, pathophysiology, differential diagnosis.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Resident, Department of Radiology, Logan College of Chiropractic, Chesterfield, MO 63006-1065.
Martha A
MA
Kaeser
Linda W
LW
Smith
Norman W
NW
Kettner