[image: Thigh mass 74M 14474874R.jpg]
[image: Thigh mass 74M 14474874R (2).jpg]
[image: Thigh mass 74M 14474874R (1).jpg]
There is an exophytic mass-like extension of the soft tissues of the
posteromedial proximal thigh with obvious skin thickening and infiltration
of the subcutaneous fat and ulceration at the caudal aspect of this mass
which contains mature ossification.
The scout is really something.
Does this have a name I should use in my report?
If there’s cortical destruction and soft tissue attenuation of marrow space
in these ossific foci in the thickened soft tissues of the posteromedial
thigh (up to 94HU) we don’t call that osteomyelitis….right?
I know that seems a stupid question, but I’ve never seen anything quite
like this.
Check out the scout, it’s quite something.
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Hilary
2 thoughts on “74M smoker with hx of HTN and Kidney Problems (not specified) referered to evaluation posterior thigh mass, CT”
hilary.umans
Dorota Linda and Tatiane Cantarelli reminded me of the name I couldn’t
recall, Massive Localized Lymphedema.
From the FOV of this CT scout, he doesn’t seem so obese…..and I cannot
find his weight listed in any field I can access
(I suppose it’s dangerous to permit the interpreting radiologists too much
sensitive information…..can you see my Sarcasm font????)
[gallery]
hilary.umans
One more interesting suggestion from Simon Osterle:
could this be a giant pedunculated lipoma? I think they can ulcerate..
I managed to get through to the referring nurse practitioner from the
clinic (he does not have a doctor)…and forgot to ask what his weight or
BMD is….but i am struck that the scout and pelvis CT images don’t seem as
if he’s all that obese——so Maybe this is pedunculated lipoma???
He’s been referred to a General Surgeon….with luck I might hope to get a
call back from the NP who promised to give me clinical follow up.
recall, Massive Localized Lymphedema.
Tatiane added:
It seems to be an ulcerated pseudosarcoma / massive localized lymphedema
with some dystrophic calcifications.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3269338/
From the FOV of this CT scout, he doesn’t seem so obese…..and I cannot
find his weight listed in any field I can access
(I suppose it’s dangerous to permit the interpreting radiologists too much
sensitive information…..can you see my Sarcasm font????)
[gallery]
could this be a giant pedunculated lipoma? I think they can ulcerate..
I managed to get through to the referring nurse practitioner from the
clinic (he does not have a doctor)…and forgot to ask what his weight or
BMD is….but i am struck that the scout and pelvis CT images don’t seem as
if he’s all that obese——so Maybe this is pedunculated lipoma???
He’s been referred to a General Surgeon….with luck I might hope to get a
call back from the NP who promised to give me clinical follow up.
[gallery]