Intraosseous lipoma of the mandible: A diagnostic challenge

Abstract

Purpose: To report a rare case of intraosseous lipoma of the mandible and to discuss the most important features of the lesion, emphasizing the diagnostic pitfall that this entity may represent for general dentists and radiologists.Case description: An 18-year-old male patient presented an asymptomatic radiolucent lesion in the mandible in the region of the teeth 43 and 44 with no clinical alteration. After the incisional biopsy the histopathological exam revealed a capsulated lesion predominantly composed of mature adipose tissue and some areas of dystrophic calcification confirming the diagnosis of intraosseous lipoma. The lesion was surgically removed and no signs of recurrence could be observed after six months of follow-up.Conclusion: Due to the unspecific clinical and radiographic features and its rarity the intraosseous lipoma of the mandible may be a diagnostic challenge for general dentists and radiologists. Therefore, the histopathological examination is required for the correct diagnosis of the lesion.Key words: Bone Tumors; diagnosis; lipoma; mandible ResumoObjetivo: Relatar um caso raro de lipoma intra-ósseo em mandíbula e discutir os aspectos mais importantes desta lesão, enfatizando a desafio diagnóstico que esta entidade pode representar para cirurgiões dentistas e radiologistas.Descrição do caso: Paciente do sexo masculino, 18 anos de idade apresentava uma lesão radiolúcida assintomática na mandíbula na região dos dentes 43 e 44 sem qualquer alteração clínica. Após a biópsia incisional, o exame histopatológico evidenciou uma lesão encapsulada composta majoritariamente por tecido adiposo benigno e algumas áreas de calcificações distróficas confirmando o diagnóstico de lipoma intra-ósseo. A lesão foi cirurgicamente removida e nenhum sinal de recorrência foi observado após seis meses de acompanhamento.Conclusão: Devido às características clínicas e radiográficas inespecíficas e à sua raridade, o lipoma intra-ósseo de mandíbula pode representar um desafio diagnóstico para cirurgiões dentistas e radiologistas. Portanto, o exame histopatológico é fundamental para o correto diagnóstico da lesão.

Intraosseous lipoma: a case report

“…It is most commonly located in the subcutaneous level, where they are clinically presented individually, well circumscribed and with slow growth behavior. In contrast with this presentation at a subcutaneous tissue level, you can find intraosseous lipoma, which is a lot less frequent and one of the rarest primary benign bone tumors (0.1% of all bone tumors) [2,3,4].…”

“…Occasions are much more frequent at a mandibular level and since 1948 only 19 cases have been reported so its etiology and characteristics are difficult to specify [2,4].…”

A Rare Case of Intraosseous Fibrolipoma of the Mandible: Diagnosis and Treatment

“…Based on the literature, the overall incidence of intraosseous lipoma represents less than 0.1% of all bone tumors [2–4] and only 20 cases, including this one [5–7], have been reported in the mandible since 1948 [8]. …”

“…According to the latest review done by de Freitas Silva et al in 2011 [5] (and to the best of the authors' knowledge) there is only one case in the literature of intraosseous fibrolipoma of the mandible [11]. …”

Bilateral hamartomatous medullary lipoma within the nasal turbinate bones in a cynomolgus monkey (<i>Macaca fascicularis</i>)

“…The tumor also develops in the skull, ilium and calcaneus [3, 4, 14, 23]. Moreover, with development of pertinent imaging studies, including computed tomographic (CT) scans and/or magnetic resonance imaging (MRI), lipomas of the skull base [17], nasopharynx [11], sphenoid bone [21, 29] and others [7, 9, 10, 13] are reported with an increasing tendency. Intraosseous lipomas are subdivided into three groups, depending on the degree of involution [24].…”