Intraosseous Lipoma Research Articles

INTRAOSSEOUS LIPOMA OF THE MANDIBLE

<h3>Background</h3> Intraosseous lipoma (IL) is an uncommon, benign lesion of the bones, making up approximately 0.1% of all primary osseous tumors. Presentation within the jaws remains particularly rare, with no more than 20 cases of mandibular intraosseous lipoma (MIL) documented within the English language literature. Its presentation is often mistaken for other entities, such as anterior Stafne bone defect, traumatic bone cavity, keratocystic odontogenic tumor, adenomatoid odontogenic tumor, and glandular odontogenic cyst. MIL has been documented with variable signs and symptoms and locations, but manifestations in the anterior mandible are especially uncommon. <h3>Discussion/Conclusions</h3> A 33-year-old Hispanic female presented with an incidental finding of a well-defined, intraosseous unilocular radiolucent lesion in the right anterior mandible that was not visible on previous radiographs. The lesion measured 30 × 20 mm, without cortical expansion, and was located apical to teeth #25, #26, and #27, which were asymptomatic. The lesion was enucleated, and the specimen was histologically confirmed to be MIL. This uncommon case of MIL has helped to better describe the features of this rare entity. The medial border of this lesion closely approximated the symphyseal midline, even when the lesion approaches the anterior mandible in only about 20% of described cases. The lesion also presented in the fourth decade of life, below the typical age of the fifth and sixth decades. Features of the current case have not been previously reported, given the small number of cases documented in the literature. Although MIL has a mild behavior and does not require aggressive surgical management, this case illustrates that it may mimic other diseases, given its location in the anterior mandible in a younger patient, thus hindering an accurate diagnosis.

Calcaneal intraosseous lipoma: A rare cause of heel pain

BackgroundIntraosseous lipoma is a rare benign tumor representing 0.1% of all skeletal tumors. We report a new case of plantar heel pain revealing intraosseous lipoma of the calcaneus. Aim of the workTo increase clinical awareness of calcaneal lipoma and to highlight the contribution of imaging in the diagnosis of patients with persistent heel pain. Case reportA 67-years-old Tunisian man presented to the Rheumatology department, Kassab Orthopaedic Institute, Faculty of Medicine, University of Tunis el Manar with a four months history of persistent left heel pain. The pain became worse during walking and disappeared at rest. He had no history of trauma. The physical examination was normal, except for tenderness to palpation of the left heel. Radiography of the left heel showed a well-defined lesion in the neck of calcaneus. Magnetic resonance imaging (MRI) was performed and showed a large lesion in the left calcaneus, well demarcated (width: 30 mm, length: 33 mm and height: 18 mm), with high signal intensity on T1 and T2 weighted sequences and low signal in T2 sequences with fat saturation without enhancement after gadolinium injection. The diagnosis of calcaneal lipoma was established and the patient was put on symptomatic treatment and referred to surgery. ConclusionCalcaneal lipoma should be mentioned as a forerunner among the differential diagnoses of persistent heel pain and promptly dealt with for a promising outcome.

Rare tumor in rare localization: humeral pallet intraosseous lipoma

A 54-years-old man referred to our medical center for intermittent pain of his left elbow. On arrival, during the medical history taking, he reported neither old trauma of the left elbow nor weight loss. Physical examination of the elbow showed neither limitation of movements nor evidence of a palpable mass nor soft tissue swelling. X-rays of the elbow showed a cystic lesion in the distal humeral metaphysis. We performed a computed tomographic scan of the arm, which demonstrated a well-defined fat density intramedullary lesion within the distal metaphysis of the right humerus without signs of cortical destruction or periosteal reaction. Completed T1-weighted Magnetic Resonance images revealed an intramedullary lesion with an equal signal intensity to subcutaneous fat. T2-weighted images also showed a high signal intramedullary lesion similar to subcutaneous fat. According to the typical imaging findings, a symptomatic intraosseous lipoma was suspected prompting the patient to undergo surgery for curettage and bone grafting. The patient´s initial postoperative course was uncomplicated and so he was discharged with an oral analgesic to be reviewed in two weeks with x-ray control of the left elbow. The histopathological findings confirmed the intraosseous lipoma of the humerus. At the last follow-up of three years, the patient showed no pain and no recurrence of the bone lesion.

Aggressive intraosseous lipoma with extraosseous extent in the proximal phalanx of the thumb

Aggressive intraosseous lipoma with extraosseous extent in the proximal phalanx of the thumb

Intraosseous lipoma: a case report

OBJECTIVE: The objective of this report was to demonstrate main clinical and histopathologic intraosseous mandibular lipoma features by taking a look at a specific case.CASE DESCRIPTION: A case of intraosseous lipoma in the anterior jaw of a 27-year-old woman is reported.CONCLUSION: The treatment of choice was surgical enucleation of the lesion, since recurrences have not been reported in the literature.

A case of intraosseous lipoma in the mandible

We report a case of intraosseous lipomas arising in the mandible. A 68-year-old man was referred to our department for evaluation of a radiolucent lesion in the right side of the mandible. The face was symmetric. No swelling of cervical lymph nodes or hyposthesia of the right lower lip was noted. The oral mucous membrane was normal despite many residual roots, and no bone eminence was palpable in the right side of the mandible. Panoramic radiography and computed tomography revealed a unilocular radiolucent lesion measuring 30 x 20 mm at the border of the right side of the mandible. On magnetic resonance imaging, the lesion showed signal intensity as high as that of fat tissue on T1- and T2-weighted images, and the signal intensity was reduced by fat suppression on T2-weighted images. The lesion was diagnosed as an intraosseous lipoma in the mandible and was extirpated via a submandibular approach with the patient under general anesthesia. The surgical specimen was elastic soft and yellowish. Histologically, the lesion consisted of proliferation of lobulated mature adipocytes. Degeneration of adipocytes and fibrosis and calcification were partly observed within the lesion. Nuclear atypia suggesting malignancy was not noted. On the basis of these findings, the lesion was histologically diagnosed to be a lipoma. The postoperative course has been uneventful, with no evidence of recurrence 2 years 10 months after surgery.

An unusual intraosseous calcaneal lipoma: case report

Intraosseous lipoma, a rare primary benign tumor of the skeleton, is most commonly found in the calcaneus. It may contain homogenous fat, but it may also contain necrosis, calcification, or ossification. It usually does not show contrast enhancement, but there is an interface enhancement between the outer fat plan and the inner fluid part. Herein, we present an unusual 22-year-old male case of calcaneal intraosseous lipoma with contrast enhancement in the fatty component. The lesion was totally curetted and replaced with bone graft. The pathological diagnosis was reported as an intraosseous lipoma. The correct diagnosis of an atypical calcaneal intraosseous lipoma is very important to prevent an unnecessary biopsy and treatment.

Maxillary Intraosseous Sclerotic (Fibroma-Like) Lipoma: a Rare Variant, Not Previously Described in the Oral Cavity

Lipomas are benign neoplasms of mesenchymal origin characterized by proliferation of adipocytes. Several histopathologic subtypes of oral lipomas, including rare cases of intraosseous lipoma, have been described. We report an extremely rare case of intraosseous sclerotic (fibroma-like) lipoma affecting the maxilla. To the best of our knowledge, this lipoma variant has not been reported in the oral cavity. A 50-year-old woman sought dental care for new dentures, and imagologic examination revealed a radiolucent lesion in the anterior maxilla. Microscopic analysis showed large areas of fibrous stroma with myxoid foci, spindle cells, mast cells, and scattered mature adipocytes. Immunohistochemical analysis showed positivity for vimentin, S100 (adipocytes), and CD99 (stroma cells), and negative results for cytokeratin, α-SMA, and CD34. The Ki-67 labeling index was less than 1%. Sclerotic (fibroma-like) lipomas are unusual variants; however, they should be considered in the differential diagnosis of intraosseous lesions affecting the jaws.

Aggressive intraosseous lipoma of the intermediate phalanges of the thumb.

Intraosseous lipomas occurring in the bones of the upper limbs are very rare. The tumor often occurs in long bones, especially the calcaneus. Usually patients with intraosseous lipomas present with mild clinical features. Thus far, bone destruction caused by the tumor has not been reported. The present study reported a case of an aggressive intraosseous lipoma that developed in the intermediate phalanges of the thumb. This is an extremely rare case with extraosseous development, which occurred at a rare site. A 47-year old woman presented to us with right thumb pain and swelling. Computed tomography and magnetic resonance imaging revealed a mass extending to the outer edge of the phalangeal bone. The patient was treated with surgery the remove the tumor. Artificial bone was used to refill the area due to the lack of cancellous bone. During the clinical management of lipomas, it is important to consider that intraosseous lipomas may spread out of the bone; moreover, the tumor should be removed immediately to help reduce the possibility of bone destruction.

Intraosseous lipoma of the mandible: a case report and short review of the literature

AbstractIntraosseous lipomas are rare, benign neoplasms that account for less than 0.1% of all bone tumours. They remain a diagnostic challenge due to their variable clinical and radiological features; consequently only 26 cases in the mandible have been reported in the literature. Here, we report an unusual finding of an intraosseous mandibular lipoma in a 68 year‐old female patient following a history of third molar extraction. We also review the clinical, radiographical and histological findings in previously documented cases of intraosseous mandibular lipomas.

Focal dermal hypoplasia: A novel finding in disguise

Focal Dermal Hypoplasia (FDH) or Goltz-Gorlin syndrome is an unusual X-linked dominant syndrome characterised by anomalies of both ectodermal and mesodermal structures.We present a case report on the management of a 58year old Caucasian male with Focal Dermal Hypoplasia. This report describes an additional clinical manifestation of an intraosseous mandibular lipoma, which has not been previously described in cases of FDH. Intraosseous lipomas in the head and neck region are reported in only seventeen cases in isolation of any associated syndrome.Diagnosis was hindered due to similitude with Nevoid Basal Cell Carcinoma Syndrome (Gorlin-Goltz Syndrome) which despite similar nomenclature, is an exclusively separate conditionThis novel finding encourages clinicians to consider unusual differential diagnoses in such cases and highlights the importance of avoiding eponyms to prevent confusion with similar conditions

Intraosseous Lipoma: 18 Years of Experience at a Single Institution.

BackgroundIntraosseous lipoma is a very rare lesion that constitutes no more than 0.1% of all bone tumors. We analyzed 21 cases of intraosseous lipoma at a single institution for clinical and radiographic characteristics.MethodsA retrospective study was performed on 21 pathologically confirmed intraosseous lipomas treated in our hospital from 2000 to 2017. Simple X-ray and magnetic resonance imaging findings and medical records were reviewed. Patients' age, sex, and clinical symptoms were investigated. From the radiographic images, the site of the lesion, calcification, bony expansion, and stage of the lesion were evaluated. Correlations between the degree of involution and clinical symptoms were analyzed.ResultsThe mean age of patients was 50 years (range, 20 to 67 years), and there were 13 males and eight females. The mean lesion size was 6.1 cm (range, 2.5 to 13.6 cm). The most common anatomical site of the lesion was the femur (seven cases), and three cases occurred in flat bones such as the ilium and scapula. Visual analogue scale score for pain was 3 to 6 in 15 patients. There were no complaints of functional limitation. There was no correlation between the degree of degeneration and clinical symptoms (p = 1.000). Curettage was performed as a surgical treatment in 20 patients, and bone graft was performed using a bone chip. Excision was performed in one patient. Pain was resolved in seven of 11 patients with a complaint of preoperative pain; intermittent pain remained in four cases. There was no local recurrence or malignant change during the follow-up.ConclusionsThere was no correlation between the degree of degeneration and clinical symptoms. Pain was the most common clinical symptom, but it was rarely accompanied by functional limitation. However, it is important to distinguish it from other pain-inducing disorders. The incidence of intraosseous lipomas is low, and detection based on various imaging findings can be difficult. Clear understanding of the radiographic findings and symptoms of intraosseous lipoma is helpful for diagnosis and differentiation.

Surgical Treatment of Confirmed Intraosseous Lipoma of the Calcaneus: A Case Series

Intraosseous lipoma of the calcaneus is a benign lesion formed by mature adipose tissue. When the lesion is symptomatic, the most frequent presentation is localized pain and soft tissue swelling. Because these lesions can regress spontaneously, conservative treatment methods are recommended. Operative excision is mostly required for painful lesions and pathologic fractures. The data from 14 patients with calcaneal intraosseous lipoma, who had undergone surgery in our clinic, were evaluated retrospectively. Using Milgram’s classification system, 9 lesions were classified as stage 1, 4 as stage 2, and 1 as stage 3. All lesions were occupying 100% of intracalcaneal cross-section in the coronal plane and >30% in the sagittal plane of magnetic resonance imaging sections. The mean preoperative visual analog scale score was 5.29 ± 1.14 (range 4 to 7), and the mean postoperative visual analog scale score at the last follow-up visit was 1.14 ± 0.36 (range 1 to 2), which was significantly better (p < .01). The mean Maryland foot score at the last follow-up visit was 97.71 ± 2.02 (range 95 to 100). The mean American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale score was 97.86 ± 2.11 (range 94 to 100) at the last follow-up visit. The differences between the pre- and postoperative values were statistically significant (p < .01). No recurrence had been detected within a median follow-up period of 84 months. Operative management of symptomatic lesions related to intraosseous lipoma of the calcaneus provides better results compared with the preoperative state.

Internal fixation combined with bone grafting for large intraosseous calcaneal lipoma: A case report.

Intraosseous lipoma is a rare benign bone tumor that has been reported to occur in the calcaneus and long bones. The etiology of intraosseous lipoma is unknown, although several theories have been proposed. The majority of the cases of intraosseous calcaneal lipoma reported in the literature were localized in the anterior portion of the calcaneus and were treated by curettage and bone grafting. However, for larger lipomas, no specific treatment protocol has been developed to date. We herein present a rare case involving a large intraosseous lipoma of the calcaneus in a 36-year-old man following hindfoot trauma. The lesion was treated by decortication followed by bone grafting and internal fixation, a surgical approach that, to the best of our knowledge, has not been previously described in the literature.

Benign periarticular, bone and joint lipomatous lesions

Benign periarticular, bone and joint lipomatous lesions are rare entities that are increasingly being identified using current imaging techniques. This pictorial review illustrates the wide range of imaging presentations of these lesions at various sites and their pathognomonic features. The main lesions reviewed include intraosseous lipoma, liposclerosing myxofibrous tumour, lipoma arborescens and intra-articular lipoma.

Intraosseous lipoma of the mandibula: A case report and review of the literature

Lipoma is a benign tumour originating from mature adipose tissue. It can occur in any place in the body where adipose tissue is located. Intraosseous lipoma is a very rare bone tumour. The authors present an infrequent case involving intraosseous lipoma of the mandible in a 32-year old man and provide a review of case studies documented earlier in the literature.

Intraosseous lipoma: retrospective analysis of 19 patients

To investigate the diagnostic and therapeutic procedures of intraosseous lipoma. From June 1986 to January 2016, 19 patients with intraosseous lipoma were treated including 12 males and 7 females, aged from 24 to 76 years, a predilection aged was from 40 to 50 years in 13 cases. Symptoms presented with pain or swelling in 15 patients, the lesions were found incidentally in 3 patients, another case was bone defect lipoma replacement after curettage of bone cyst for 4 years. On plain X-ray flims of all bones showed a well-circumscribed radiolucent area. Diagnosis was established with CT or MRI. Among them, 16 cases were treated by surgical operation, 3 cases were treated by concervative treatment. All patients' clinical data, histologic findings and X-ray, CT and MRI were analysed. Total 19 patients were followed up from 9 to 42 months with an average of 15 months. There was no local tumor recurrence in 16 patients after excising the tumors, the remaining 3 patients showed no enlargement of the lesion. Surgical intervention is considered as an unnecessary in the patients diagnosied intraosseous lipoma by MRI or CT. Patients with symptomatic should adopt surgical treatment with curettage and bone grafting.

Intraosseous Lipoma of Calcaneus as a Rare Cause of Heel Pain

Bone lipoma is a rare, primary and benign tumor. In recent years, its detection rate is higher as a result of the increasing use of accurate and more detailed cross-sectional imaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) plus the utilization of advanced histological diagnostic facilities. The radiographic appearance on x-ray is not usually characteristic of this lesion and therefore requires differential diagnostics conducted for a long time. However, CT and MRI allow for a tissue-specific diagnosis. The microscopic features are usually those of mature adipose tissue. Sometimes, still, pathological reports may show discordance with radiologic findings. For optimal management, surgical curettage and packing with autogenous bone grafts is usually recommended if the lesion is causing the pain or if the correct diagnosis cannot otherwise be obtained. Our case is a 43-year-old female patient who presented to our clinic with chronic left foot pain. Pain was localized over the left heel with radiation to surrounding areas. The radiological diagnosis of intraosseous lipoma was made based on CT imaging and confirmed later through biopsy. Surgical intervention was needed after failure of conservative management. Curettage of all lesion and packing with autogenous bone grafts was done. Postoperatively, the patient showed remarkable improvement and follow up consultations showed good healing and no signs of recurrence.

PP - INTRAOSSEOUS MANDIBULAR LIPOMA: A DIAGNOSTIC CHALLENGE

A 20-year-old white female presented at FAESA Dental School, with the chief complain of a painless swelling at the right mandible. The lesion was present since she was 12 years old and progressed in the last 2 years. Her medical history was unremarkable. Intraoral examination evidenced a firm, round swelling at the right inferior premolar region, with slight teeth displacement. Occlusal radiography and computed tomography showed low radiopacity and evident cortical expansion at both buccal and lingual aspects of the mandible. An incisional biopsy was performed and the specimen analyzed at the Pathology Service of the Bauru School of Dentistry. Histopathological analysis revealed extensive areas of mature, S-100 positive adipose tissue, interspersed with trabecular viable bone without capsular tissue. Based on clinical, radiographic and microscopic findings, the final diagnosis was of intraosseous lipoma. The patient was submitted to surgical removal of the lesion, preserving the teeth, and is being monitored regularly. Although extremely rare in the jaws, the histopathological analysis is of utmost importance in differential diagnosis of intraosseous lipoma and similar pathologies of the jaws.

Intraosseous lipoma of ilium: A rare case report with review of literature

Intraosseous lipoma (IL) is a rare benign bone lesion, and it constitutes about 0.1% of all bone tumors. The majority of cases are located in the metaphyseal region of the long bones in the lower limbs. We report a rare case of lipoma of the ilium in a 12-year-old male child presenting with mass over the right gluteal region. Meticulous marginal dissection was done, and a pedunculated mass originating from the lower right sacroiliac region was excised in toto. The case was an atypical example of an IL with a large outgrowth involving sacroiliac region with inconclusive magnetic resonance imaging and needle biopsy findings.