Multimodality imaging features of parosteal lipomas

Akriti Khanna, Nathan L. Eickstaedt, Doris E. Wenger, Stephen M. Broski

Research output: Contribution to journalArticlepeer-review


Objective: To examine the multimodality imaging characteristics of parosteal lipomas. Materials and methods: With IRB approval, our institutional imaging database and medical record were retrospectively reviewed from 1990–2020 for cases of pathologically-proven and/or imaging diagnosed parosteal lipomas. Results: There were 22 patients (12 males, 10 females) with a mean age of 57.1 ± 12.7 years (range 31–80 years). 11/22 cases (50%) were pathologically-confirmed on biopsy or surgical resection and 11/22 (50%) had imaging features compatible with parosteal lipoma. Lesions occurred most commonly along the femur (8/22, 36%), followed by the forearm (3/22, 14%). All cases demonstrated a juxtacortical fatty mass containing an osseous excrescence that was firmly attached to the cortical surface. The osseous excrescences were characterized as pedunculated in 16/22 (73%) and sessile in 6/22 (27%). The average largest dimension of the osseus excrescences was 2.4 ± 1.6 cm (range 0.8–6.1 cm) and the lipomatous portions 7.8 ± 3.8 cm (range 2.0–19.5 cm). The excrescences contained mature bone in 12/22 (55%) cases and a mixture of mature bone and radiating bone spicules in 10/22 (45%). There were non-lipomatous elements in the fatty portion of the mass in 13/22 (59%) of cases. Most cases (19/22, 85%) had cortical thickening/periostitis near the base of the osseous stalk. Two patients had a bone scan that demonstrated uptake in the osseous excrescence, and two patients had an FDG PET/CT that demonstrated no uptake. Conclusion: Parosteal lipomas are a rare benign lipomatous tumor with pathognomonic multimodality imaging features that may obviate the need for biopsy.

Original languageEnglish (US)
Pages (from-to)1767-1775
Number of pages9
JournalSkeletal Radiology
Issue number9
StatePublished - Sep 2023


  • Parosteal lipoma
  • juxtacortical fatty mass
  • lipomatous tumor
  • multimodality imaging
  • osseous excrescence

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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