February 21, 2012

Soft Tissue Lipoma

A longitudinal ultrasound image of the back (behind the scapula) shows a well-circumscribed, oval, solid mass (arrows) with internal slight hyperechogenicity superficial to the deep muscle.

Facts: Soft Tissue Lipoma
  • Very common mesenchymal tumors
  • May be palpable, painless, soft and mobile on clinical examination
  • May be multiple in up to 5% of cases
  • Common in patients older than 50 years
US Findings
  • Classic lipomas are hyperechoic and homogeneous (compared with muscle) with well-defined borders
  • Sonographic appearance may depend on internal cellularity (amount of fat and water in the lesion). Lesions with pure fat are hypo- or anechoic but those with mixed fat/water are quite echogenic
  • Appearance highly variable from hyper-, iso-, hypoechoic or mixed echoic and bordes can be circumscribed or poorly defined
  • It can be difficult to confidently diagnose lipoma on US, accounting for variable US features and high interobserver variability on description of lesions.

Our case: soft tissue lipoma proven by histopathology

Reference:

Inampudi P, Jacobson JA, Fessell DP, et al. Soft-tissue lipomas: accuracy of sonography in diagnosis with pathologic correlation. Radiology 2004;233:763-767.

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