PMC6122152_01
Coronal Oblique Proton Density Image demonstrates an elliptical intramuscular mass (white arrow) in the superior aspect of the right supraspinatus muscle. The signal is homogeneous and identical to subcutaneous fat signal.
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The MRI identified a 35 x 17 x 18 mm ovoid intramuscular mass lesion within the superior aspect of the supraspinatus muscle (Fig. 1).
Sagittal Oblique T1 weighted image demonstrates the fat signal mass within the supraspinatus muscle belly (arrow).
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The lesion followed fat signal on all sequences including fat saturated sequences and did not contain any thick septations or nodular components, consistent with a benign intramuscular lipoma (Fig. 2).
Intra-operative view with the lipoma partially dissected out from the supraspinatus muscle belly via a supraspinous approach.
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The supraspinatus was exposed and a small perimuscular component of the lipoma was excised prior to excision of the intramuscular lipoma in the substance of the body of supraspinatus via a longitudinal split in the muscle, taking care to protect the suprascapular nerve (Fig. 3).
Post-operative macroscopic image of excised intramuscular lipoma from the substance of the body of supraspinatus.
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The macroscopic specimen is shown in Fig. 4.