Condylar intramedullary intraosseous lipoma: Contribution of a new case and review of the literature.

A Sanjuan,A Blanco,B Garcia,E Roldan,F Alamillos,A Dean

doi:10.4317/jced.53421

Abstract

BackgroundLipoma is the most common benign tumour of the human body, being intraosseous involvement very rare. Just 1 to 4% of all cases of lipoma are located in the oral cavity, only 0.1% being intraosseous. The jaw is its most uncommon bone location. Etiology of intraosseous lipoma (IOL) is unknown, although several theories have been proposed. Usually asymptomatic, the symptoms, when present, will depend on its location and size. Its origin may be intraosseous or juxtacortical. A biopsy is essential for diagnosis, and definitive treatment involves resection or curettage of the lesion. The aim of this paper is to present a new case of intramedullary intraosseous lipoma of the mandible with involvement of the left mandibular ramus and condylar neck.Material and MethodsA case of intramedullary intraosseous lipoma (IOL) on the left mandibular ramus and condyle is presented. No history of trauma in temporomandibular joint existed. The radiology showed a radiolucent multi-lobulated lesion with values of attenuation in the range of fat. Curettage is performed and the histopathology showed a conglomerate of adipocytes without trabeculae, calcifications or atypia.ResultsAccording to the bibliography 24 cases of mandibular IOL have been described. This is the second reported case of condylar involvement and the first with cortical expansion.ConclusionsLipoma intraosseous is a very rare benign bone neoplasm. Histology is required for the differential diagnosis from other radiolucent lesions. The IOL treatment is the curettage with a good prognosis, although malignant transformation to liposarcoma has been reported in other locations. It is a disease with a difficult differential diagnosis, therefore the publication of new cases is important. Key words:Intraosseous lipoma, lipoma, jaw tumour, condylar tumour.

Highlights

Lipoma is a circumscribed, slowly growing benign mesenchymal tumour, formed by a conglomerate of mature adipocytes without cell atypia
The aim of this paper is to report a new case of mandibular intraosseous lipoma (IOL) along with a review of the literature and an update of the pathogenesis, symptoms, radiologic images, management and current treatment
In 1969, Hart studied the location of intraosseous lipoma and its relationship to the bone, establishing four categories: lipoma from the surrounding soft tissue, intraosseous lipoma of the intramedullary cavity, periosteal lipoma which may deform the bone by pressure or periosteal reaction, and the liposarcoma, a malignant tumour with local destruction and possible distant metastasis [11]

Summary

Introduction

Slowly growing benign mesenchymal tumour, formed by a conglomerate of mature adipocytes without cell atypia It can be found in multiple locations due to the wide distribution of fat tissue throughout the body. A radiolucent, multi-lobed, well circumscribed lesion, in the left mandibular ramus and condyle (Fig. 1). A magnetic resonance imaging (MRI) revealed a hyperintense lesion in T1 and T2 weighted sequences, a typical signal of fat (Fig. 2) All these features were consistent with the diagnosis of intraosseous lipoma. Case Report A 50 year-old female was referred to our service because of a radiolucent image on the left mandibular ramus and condyle discovered in a radiographic examination. Patient inform consent has been obtained for the publication of this article

Discussion

Findings

F Parasymphysis