Presentation
Right hip pain.
Patient Data
Right iliac bone osteolytic lesion with sclerotic septations and thin zone of transition. It reaches the roof of acetabulum.
Right iliac bone multilocular cystic lesion with bone septations. It is mildly expansile and reaches roof of acetabulum. Intact bone cortex with no extraosseous component.
Right iliac bone expansile multilocular lesion with areas of fluid signal (cystic areas) and rest of the lesion is composed of areas of high signal on T1 and T2 with complete suppression of signal on fat sat sequences (STIR and PD fat sat) reflecting fat nature.
The patient was referred to true-cut biopsy of the lesion to confirm the diagnosis.
Pathology report
Specimen: Core biopsy
Gross: Multiple yellowish brown tissue cores, measured up to 1.5 cm, totally submitted
Microscopic: Sections examined from the specimen received revealed cores of bone with intervening marrow. An area showed intervening mature adipocytes devoid of marrow. No malignancy.
Diagnosis: Right iliac bone osteolytic lesion, core biopsy. Findings in favor of intraosseous lipoma.
Case Discussion
Imaging features are of right iliac bone intraosseous lipoma with multiple bone cysts. Involvement of the iliac bone is rare. Intraosseous lipoma can be associated with cystic changes in about 67% of cases 1.