Female, 48 years old. Right thigh soft tissue mass, enlarging over the past year. A marker was placed along the anteromedial aspect of the right mid thigh. Deep to the marker is a mass of predominantly fat signal intensity measuring approximately 8 x 6 cm in transverse dimension and approximately 9 cm in oblique craniocaudal dimension. Within the fatty mass are small round and curvilinear foci of intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images, showing minimal if any enhancement, with the exception of a 1 cm focus of enhancement anteriorly within the mass just below the skin surface. The mass does not invade the musculature of the thigh, and we see no additional masses.Severe osteoarthritis affects the knee. A 1 cm focus of intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images within the intertrochanteric region of the femur showing mild enhancement is nonspecific. Uterine fibroids are incompletely imaged.
1.Fatty mass in the anterior subcutaneous fat containing some nonadipose elements. This may simply represent a subcutaneous lipoma with benign nonadipose elements due to repeated trauma. An angiolipoma is also considered in the differential diagnosis, but lack of enhancement would be atypical. An atypical lipomatous tumor is also considered in the differential diagnosis.2.A 1 cm round enhancing focus in the intertrochanteric region of the right femur is nonspecific. We suspect that this is benign and of no clinical significance, perhaps representing a small benign cartilaginous rest. However, if the patient has a known primary tumor, then a skeletal scintigram could be considered to evaluate for potential metastatic disease.