Thanks for the many comments…it’s so great.Most everyone insisted it is benign…and even question if there has been real interval growth, though I stand by my caliper measurements—-I gather benign things can grow in 8 years.
Not surprisingly, it’s the lack of endosteal scalloping, cortical destruction or STM that Mark Murphey and others point to as indicative of the benign nature of the lesion.
Mark is holding onto that diagnosis of LSMT, though there are many (among us) who believe they are all Fibrous Dysplasia.
For what it’s worth…I’ve always been scared by the 10% risk of malignant transformation Mark and friends published years ago for LSMT—-apparently he does not believe that…said that true malignant transformation is extremely rare.
I asked about surveillance, he said: We suggest these lesions just be followed clinically unless there are new localized symptoms to that area.
So….much ado about nothing, it seems—-but I learned something, so I’m happy.
Thanks for all of the comments / advice, it’s really very helpful.
Hilary
On Tue, Mar 28, 2023 at 9:28 AM hilary umans <hilary.umans> wrote:
He has chronic pain, no hip DJD, but dextroscoliosis and lower lumbar DDD.In 2015 I gave a DDx of LSMFT, ossifying lipoma or involuting intraosseous lipoma (there is macroscopic fat signal on motion degraded MRI).
There are no aggressive XR features today, but there is this interval growth.
What do you think? Is that too much growth? How much is too much after 8 years?
I’m holding my report pending good advice…pleeeeease….
