Intertrochanteric Lipoma

This is an incidental, "leave-me-alone" lesion. Its expansile character on the anterior aspect of the intertrochanteric aspect of the left femur may at first remind the reader of a sessile osteochondroma. However, there are two powerful reasons why this is not a chondroid lesion:

1. The calcified 'matrix' is definitely not chondroid, lacking the typical arcs and rings that bespeak of the lobulated architecture of chondroid lesions.

2. Even in the event that the reader misinterpreted the calcification as chondroid, there would be a logical contradiction in the reasoning. Evidently, if any chondroid lesion could potentially be considered, that is an osteochondroma, given the protuberance that it produces eccentrically on the anterior cortex. Therefore, any calcification in the chondroid component would be located on top of the exostosis, rather than within its core, since it is at the top where the cartilaginous cap resides.

Lipomas, either in the calcaneus or in the proximal femur, tend to develop these coarse calcifications in the center. In the proximal femur, it is also common to see reinforced trabeculae around the lesion.

For those prone to intellectual relativism, I have included the CT-scan with a measurement of > - 80 HU within the excrecence.