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Intraosseous lipomas most commonly occur in the calcaneus and contain intralesional fat with variable central cystic changes and calcifications. The Milgram staging system is based on sequential histopathologic and radiographic features of intraosseous lipomas; however, the usefulness of this staging system for the calcaneus should be questioned because IOLs of the calcaneus may belong to the maturational continuum of an intraosseous ganglion cyst.






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Intraosseous "Lipoma" of the Calcaneus Developing in an Intraosseous Ganglion Cyst

Free full text article: Intraosseous

Abstract
Intraosseous lipomas are rare primary bone tumors, most common to the calcaneus. There are several proposed theories of the natural etiology of intraosseous lipomas; however, all lack definitive support. In this report, an 18-year-old man presented with radiologic evidence of a simple bone cyst of the calcaneus. Over a 4-year period, the patient was followed with interval magnetic resonance imaging. The cyst demonstrated progressive development of peripheral intralesional fat with final magnetic resonance imaging features characteristic of an intraosseous lipoma. To our knowledge, this is the first longitudinal study that shows gradual peripheral fat deposition within an intraosseous ganglion cyst, illustrating a potential cause of intraosseous lipomas of the calcaneus.






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