PMC5952549_01
Lateral x-ray of the left wrist shows a mass with internal calcifications at volar aspect of left distal forearm. The low density of the lesion on radiograph likely signifies a lesion that is fat-predominant.
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F1
Initial radiograph revealed a lobulated mass at the subcutaneous region of left volar forearm and wrist, of mixed low density and calcifications [Figure 1]; the lesion showed no connection to the underlying radius or ulna, nor was it located right adjacent to the bony structures.
Ultrasound reveals a spheroid hyperechoic lesion with internal heterogeneity. A continuous hyperechoic rim with posterior shadowing is present, suggestive of calcifications, and is in keeping with x-ray findings.
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F2
Ultrasound showed a spheroid hyperechoic lesion with internal heterogeneity, located at a perimuscular location close to the flexor digitorum muscles [Figure 2].
MRI T2-weighted fat suppressed sequence (left) and T1-weighted sequence (right). A well-demarcated T1 hyperintense lesion is noted compressing on the flexor digitorum superficialis and flexor carpi radialis muscles. The lesion shows fat suppression.
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F3
Magnetic resonance imaging (MRI) revealed a T1- and T2-weighted hyperintense lesion at volar aspect of left distal forearm [Figures 3 and 4] situated deep to the fascia and compressing on the flexor digitorum superficialis and flexor carpi radialis muscles.
MRI examination with T1-weighted post-gadolinium sequence in sagittal view. The fat-contaning lesion shows no significant contrast enhancement. No invasion into adjacent muscles detected.
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F4
Magnetic resonance imaging (MRI) revealed a T1- and T2-weighted hyperintense lesion at volar aspect of left distal forearm [Figures 3 and 4] situated deep to the fascia and compressing on the flexor digitorum superficialis and flexor carpi radialis muscles.
Intraoperative photograph showing a well-demarcated oval tumour.
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F5
Intraoperatively, the mass was found below subcutaneous layer, sitting on the pronator quadratus muscle [Figure 5].
Histological views of the osteolipoma. The tumour consists of adipose tissues with a few foci of ossification. Lipoblasts are not present and there is no feature of malignancy.
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F6
Histological examination revealed adipose tissues with a few foci of ossification [Figure 6].