Summary
The patient is a 44-year-old male machinist who has noticed pain in the right hip for approximately one year. This led to evaluation with imaging studies showing a lesion in the proximal femur adjacent to the lesser trochanter.
Plain radiographs, CT scan, bone scan are shown at the left. Please click on the thumbnails for a larger image. There is a mixed lytic and sclerotic lesion in the proximal femur, centrally located in the intramedullary space, just above the lesser trochanter. The cortex does not appear to be violated. The area in the center of the lesion is lucent without matrix. Surrounding this is a very dense area of sclerosis which is somewhat irregular.
Complete Information on this Tumor
This tumor is usually in the proximal femur.. A diagnosis must be based on the combination of the location and appearance with the predominant histological pattern. These lesions are usually incidental findings. The age range is broad, usually adults, The tumors probably arise in childhood. Their appearance may evolve slowly over time.
The tumor is a polymorphic fibro-osseous tumor of bone, also called a liposclerosing myxofibrous tumor of bone. On pathology, the lesion is composed of crudely woven bone that may have a pagetoid appearance. surrounded by fibrous tissue. Fat and myxoid change may also be present. The lesion may mimic fibrous dysplasia.
Hum Pathol. 1993 May; 24(5): 505-12.
Polymorphic fibro-osseous lesions of bone: an almost site-specific diagnostic problem of the proximal femur.
Ragsdale BD.