Korean J Radiol.  2008 Dec;9(6):563-567. 10.3348/kjr.2008.9.6.563.

Chondrolipoma in the Pelvic Cavity: a Case Report

• Hwang HS
• Lee WJ
• Lim HK
• Chun HK
• Ahn GH

• KMID: 1118880
• DOI: http://doi.org/10.3348/kjr.2008.9.6.563

Abstract

A chondrolipoma is an extremely rare form of a benign mesenchymal tumor containing mature cartilage and fatty tissue. Chondrolipomas may be found in almost any part of the body, particularly in the connective tissue of the breast, head and neck area, as well as in the skeletal muscle. However, to the best of our knowledge, chondrolipomas located in the pelvic cavity have not been reported. In this case report, we describe a case of a chondrolipoma in the pelvis, and show that it has its own characteristic imaging findings, which included the composition of fatty tissue and calcification in most parts, as well as some focal areas of chondroid tissue based on the CT and MR findings.

Keyword

Chondrolipoma; Lipoma; Fatty tumor

MeSH Terms

Chondroma/*diagnosis
Humans
Lipoma/*diagnosis
Male
Mesenchymoma/*diagnosis
Middle Aged
Pelvic Neoplasms/*diagnosis
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Chondrolipoma in pelvic cavity in 55-year-old man. A, B. Transverse (A) and coronal (B) CT images show 8 cm, well-defined mass occupying left side of presacral space of pelvic cavity. Mass seems to have long stalk arising from left gluteus medius muscle. Stalk traverses along surface of left iliac bone, and further passes through left sciatic foramen, and finally connects with mass. Mass is mainly composed of fatty tissue and calcification. Note that calcifications in mass are located peripherally in linear and rosary pattern, with most of stalk becoming calcified. There are some focal areas of intermediate attenuation (arrows) between fat tissue and calcification, which corresponds to chondroid tissue histologically. C-E. Plain T1-weighted transverse (C), T2-weighted transverse (D), T2-weighted coronal (E) MR images without fat suppression show same mass mainly composed of hyperintense areas and signal void areas on both T1- and T2-weighted images which represent fatty tissue and calcification, respectively. Also seen are focal areas of intermediate signal intensity (arrows), which corresponded to chondroid tissue, as seen on CT images. F, G. Gadolinium-enhanced T1-weighted sagittal MR images without fat suppression, obtained 30 seconds (F) and 3 minutes (G) after contrast injection, show same fatty mass with extensive calcifications. Note focal areas of intermediate signal intensity around calcifications (arrows) in F become isointense as with surrounding fatty tissue in G. This represents delayed enhancement. H. Cut surface of resected specimen shows 13 cm, yellowish mass with whitish area in upper portion, which inidcates that this mass is composed of yellowish fatty tissue and whitish calcification. I. Photomicrograph of resected specimen indicates mature, fatty (black arrows), chondroid (white arrows), and fibrous (white arrowheads) tissues (Hematoxylin & Eosin staining, ×100). These findings are consistent with chondrolipoma.

Reference

1. Banev SG, Filipovski VA. Chondrolipoma of the breast: case report and a review of literature. Breast. 2006. 15:425–426.

2. Fushimi H, Kotoh K, Nishihara K, Fujinaka H, Takao T. Chondrolipoma of the breast: a case report with cytological and histological examination. Histopathology. 1999. 35:478–479.

3. Hietanen J, Makinen J. Chondrolipoma of the tongue. A case report. Int J Oral Maxillofac Surg. 1997. 26:127–128.

4. Halaas YP, Mra Z, Edelman M. Chondrolipoma of the oropharynx. Ear Nose Throat J. 2001. 80:146–147.

5. Candocia FJ, Barlev DM. Chondrolipoma in the palm of a child: sonographic and MR findings. Clin Imaging. 2004. 28:206–208.

6. Ohtsuka H. Chondrolipoma of the popliteal fossa and Japanese reports. J Dermatol. 2006. 33:202–206.

7. Stout AP. Mesenchymoma, the mixed tumor of mesenchymal derivatives. Ann Surg. 1948. 127:278–290.

8. Jung HR, Park WH, Choi SO, Kwon KY, Lee SS. Intestinal chondrolipoma: uncommon cause of bowel obstruction. J Pediatr Surg. 2007. 42:E21–E23.

9. Orui H, Ishikawa A, Tsuchiya T, Takahara M, Ito M, Ogino T. Chondro-osseous differentiation in fat tissue tumors: magnetic resonance imaging with pathologic correlation. Skeletal Radiol. 2000. 29:459–465.

10. Ito R, Fujiwara M, Takagaki K, Nagasako R. Chondrolipoma of the toe. J Dermatol. 2007. 34:570–572.

11. Nakano M, Arai E, Nakajima Y, Nakamura H, Miyazono K, Hirose T. Immunohistochemical study of chondrolipoma: possible importance of transforming growth factor (TGF)-betas, latent TGF-beta binding protein-1 (LTBP-1), and bone morphogenetic protein (BMP) for chondrogenesis in lipoma. J Dermatol. 2003. 30:189–195.

12. Mutinelli F, Vascellari M, Melchiotti E, Bigolaro M, Bozzato E. Intra-pelvic chondrolipoma in a dog. J Comp Pathol. 2007. 137:160–164.

13. Milchgrub S, McMurry NK, Vuitch F, Dorfman HD. Chondrolipoangioma. A cartilage-containing benign mesenchymoma of soft tissue. Cancer. 1990. 66:2636–2641.

14. Ganzer D, Follak N, Lorenz G. Cartilage and bone containing benign mesenchymoma of the thigh and popliteal fossa. Int Orthop. 2000. 24:115–117.