OSTEOLIPOMA OF THE MAXILLARY BONE: A CASE SERIES
Authors:
Alessandro Piccirilli, Danilo Di Giorgio, Georgios Zotos, Andrea Battisti, Paolo Priore, Marco Della Monaca, Valentino Valentini
Affiliation:
Sapienza University of Rome - University of L’Aquila
Doi: 10.54936/haoms242p18
ABSTRACT:
Objectives: Lipomas are benign mesenchymal neoplasms of soft tissue that can be found commonly in any part of the human body. A rare lipoma variant, known as an osteolipoma or an ossifying lipoma, may occur; however, little has been written about this type of lipoma characterized by a classical lipoma with areas of osseous metaplasia. The purpose of this paper is to present a cases of osteolipomas in the maxillofacial district, their radiological findings and the histopathology.
Materials and methods: TOur case report focuses on the diagnostic, therapeutic and histopathological study of three cases of neoformations in the context of the maxillofacial district attributable to intraosseous lipomatous masses in our department Policlinico Umberto I (Rome) in 2023: CASE 1: 41 x 22 x 29 MM involving the right hemimaxilla, including tooth 15 and 16. CASE 2: 8 x 7 x 5 mm nodule of soft tissue, well defined and circumscribed with an irregular ossicalcificated core, attached to the anterior lateral profile of the left mandibular branch. CASE 3: high signal lesion at the right preauricular region.
All patients were studied by CT of the facial mass to highlight the location and size of the neoformation. In the third case in particular, the occasional finding was found after an MRI examination.
Results: All the patients were treated by removal and contextual reconstruction of the surgical gap: with Bichat fat pad flap and local mucous flaps in the first case and in the other two patients with a surgical excision and curettage of the site.
Histopathological studies: Histological exam revealed, in the first patient, an slight thinning of the cortical bone, rarefaction of trabecular component and an exuberant replacement of intertrabecular spaces by mature adipose tissue; the second and the third case the lesions were made up by polymetric mature adipocyte with multiple foci of ossification and cartilaginous metaplasia. In all of them no atypical adipocities were spotted, and relayed on these histopathological findings, we made up the diagnosis of osteolipoma.
Conclusions: Osteolipoma is a rare soft tissue neoplasm which has a wide range differential diagnosis including malignant processes. Recognising this benign tumor through an awareness of presenting sign and symptoms, radiological features and histopathology findings is important for patient reassurance as well as avoiding unnecessary radical treatment.
The few cases in the literature highlight a need for the clinician and pathologist to keep this entity in mind when considering the radiographic and clinical differential diagnoses for these lesions. Histopathological diagnosis according to the criteria mentioned in this review will help to categorize these rare lesions and further understand their origin. Despite their benign nature and lack of recurrence, it is important to differentiate them from liposarcomas when presented with clinical evidence of malignancy.
KEY WORDS:
Authors:
Alessandro Piccirilli, Danilo Di Giorgio, Georgios Zotos, Andrea Battisti, Paolo Priore, Marco Della Monaca, Valentino Valentini
Affiliation:
Sapienza University of Rome - University of L’Aquila
Doi: 10.54936/haoms242p18
ABSTRACT:
Objectives: Lipomas are benign mesenchymal neoplasms of soft tissue that can be found commonly in any part of the human body. A rare lipoma variant, known as an osteolipoma or an ossifying lipoma, may occur; however, little has been written about this type of lipoma characterized by a classical lipoma with areas of osseous metaplasia. The purpose of this paper is to present a cases of osteolipomas in the maxillofacial district, their radiological findings and the histopathology.
Materials and methods: TOur case report focuses on the diagnostic, therapeutic and histopathological study of three cases of neoformations in the context of the maxillofacial district attributable to intraosseous lipomatous masses in our department Policlinico Umberto I (Rome) in 2023: CASE 1: 41 x 22 x 29 MM involving the right hemimaxilla, including tooth 15 and 16. CASE 2: 8 x 7 x 5 mm nodule of soft tissue, well defined and circumscribed with an irregular ossicalcificated core, attached to the anterior lateral profile of the left mandibular branch. CASE 3: high signal lesion at the right preauricular region.
All patients were studied by CT of the facial mass to highlight the location and size of the neoformation. In the third case in particular, the occasional finding was found after an MRI examination.
Results: All the patients were treated by removal and contextual reconstruction of the surgical gap: with Bichat fat pad flap and local mucous flaps in the first case and in the other two patients with a surgical excision and curettage of the site.
Histopathological studies: Histological exam revealed, in the first patient, an slight thinning of the cortical bone, rarefaction of trabecular component and an exuberant replacement of intertrabecular spaces by mature adipose tissue; the second and the third case the lesions were made up by polymetric mature adipocyte with multiple foci of ossification and cartilaginous metaplasia. In all of them no atypical adipocities were spotted, and relayed on these histopathological findings, we made up the diagnosis of osteolipoma.
Conclusions: Osteolipoma is a rare soft tissue neoplasm which has a wide range differential diagnosis including malignant processes. Recognising this benign tumor through an awareness of presenting sign and symptoms, radiological features and histopathology findings is important for patient reassurance as well as avoiding unnecessary radical treatment.
The few cases in the literature highlight a need for the clinician and pathologist to keep this entity in mind when considering the radiographic and clinical differential diagnoses for these lesions. Histopathological diagnosis according to the criteria mentioned in this review will help to categorize these rare lesions and further understand their origin. Despite their benign nature and lack of recurrence, it is important to differentiate them from liposarcomas when presented with clinical evidence of malignancy.
KEY WORDS: