Intraosseous lipoma within the femoral head. A case report. Intraosseous lipoma occurring within the femoral head seems not to have been previously reported. Symptoms associated with the tumor included slowly increasing pain and a cystic lesion shown on roentgenograms. Management was by total hip arthroplasty. Pathologic examination of the specimen showed that the tumor was composed almost entirely of mature adipose tissue in keeping with a diagnosis of Stage 1 intraosseous lipoma. A sclerotic border and osteoid seams were noted, two features that seem not to have been previously reported in early lesions. Recent papers suggest intraosseous lipomas are more common than previously thought, and the femur now accounts for 25% of reported cases. 