Key result
Complete surgical excision of a giant gluteal mass mimicking liposarcoma confirmed a benign intramuscular myolipoma after non-diagnostic percutaneous biopsies.
Case Report (n=1)
Large deep-seated myolipomas can radiologically mimic liposarcoma, requiring surgical excision for definitive diagnosis and treatment.
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Myolipoma warrants inclusion in the differential of septated gluteal masses; leaves open need for larger series on imaging specificity.
Myolipoma is an exceptionally rare benign mesenchymal neoplasm composed of mature adipose tissue admixed with smooth muscle elements. We report a 67-year-old male who presented with a 3-month history of a progressive, painless mass in the right gluteal region. Ultrasound and magnetic resonance imaging revealed a large (125 × 88 × 60 mm) encapsulated intramuscular mass with thick enhancing septations and restricted diffusion, raising high suspicion for well-differentiated liposarcoma. Two sequential ultrasound-guided core needle biopsies were non-diagnostic. Complete surgical excision was performed; intraoperative findings demonstrated a well-encapsulated lesion with no invasion of surrounding structures. Definitive histopathology confirmed a benign intramuscular myolipoma. This case underscores that large deep-seated myolipomas can radiologically mimic liposarcoma, that percutaneous biopsy may be non-representative, and that surgical excision remains both the definitive diagnostic and therapeutic gold standard.
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Bahij et al. (2026) conducted a case report in Intramuscular myolipoma (n=1). Complete surgical excision was evaluated. Complete surgical excision of a giant gluteal mass mimicking liposarcoma confirmed a benign intramuscular myolipoma after non-diagnostic percutaneous biopsies.
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