Osteolipoma in the parapharyngeal space

Osteolipoma of head and neck - a review

OBJECTIVE

Due to the rarity of osteolipoma, current knowledge and understanding of its' clinical presentation, management, radiological features, histological characteristics, and prognosis are lacking and can present a clinical conundrum to clinicians and histopathologist alike, given wide range of differential diagnoses. This paper aims to compile, analyse and present details to augment the available literature on osteolipoma in the head and neck.

METHODS

A comprehensive literature search on PUBMED/MEDLINE, EMBASE, CINAHL and Science Citation Index, Google scholar and Cochrane database for osteolipoma in head and neck was performed up to the 1st May 2021. Reference lists from the relevant articles were then inspected and cross-referenced and any other pertinent publications were added to the review.

RESULTS

A total of 38 cases were identified from the literature. The commonest sites of involvement within the head and neck region were the oral cavity in 21 (56.8%) patients, followed by the neck in 7 (19.0%) patients. 29 (78.4%) patients presented with soft tissue swelling or mass making it the most common presenting feature. All patients had the tumour excised surgically; of which 18 (48.6%) were excised via transoral approach and 6 (16.2%) via open transcervical approach including 1 lateral pharyngotomy. 12 papers documented long-term follow-ups (median 12 months) with no recurrence. Only 1 regrowth was reported after 5-years.

CONCLUSIONS

Osteolipoma is a rare soft tissue neoplasm which has a wide range differential diagnosis including malignant processes. Recognising this benign tumour 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.

Intraparotid Osteolipoma: Treatment Option and Surgical View

ABSTRACT

Osteolipoma is a benign neoplasm originating from the mesenchymal fat tissue cells and characterized by the presence of bone formation. In the head and neck district osteolipoma has been described as parapharyngeal, nasopharinx, submandibular gland, eyelid, floor of the mouth, and skull base lesion. Only 1 case of osteolipoma was reported as a neoplasm of the parotid region. Considering the rarity of the osteolipoma, our purpose was to describe the first case of totally intraparotid gland localization of osteolipoma and summarize and review the actual literature concerning the presence of this tumor in the region of major salivary glands. A 56-years-old male patient was treated for intraparotid osteolipoma. Surgical removal of tumor was done with a standard preauricular/cervical incision and blunt dissection. The facial nerve was identified and preserved completely. In the reviewed series, all cases were reported in adult patients with a relative long history of slow progression. According to our paper and the review of the literature, we can assess that Osteolipoma is an extremely rare lesion affecting the major salivary glands, which should be considered along with common salivary gland tumors in the differential diagnosis.

Ossifying Lipoma in Costal Arches That Suggest Extensive Pulmonary Involvement: Case Report

Background:

Lipomas are the most common benign soft tissue tumors in the general population. These lesions can appear on any part of the body and usually develop in the subcutaneous superficial tissue. Lipomas that show ossifying changes are very rare, representing less than 1% of the reported lipomas. They usually manifest as hard nodular lesions in the head and neck, the extremities, the sternoclavicular region, and the subcutaneous tissue in general; they are rare in the costal arches.

Case presentation:

We report the case of a patient with a history of multiple diseases and 2 tumor-like lesions with internal lytic areas detected in the fourth right costal arch and in the eighth left costal arc; we describe his clinical manifestations, radiological and laboratory findings as well as the pathological results and outcome.

Conclusions:

Ossifying lipomas are rare benign tumors with asymptomatic clinical presentation. It is important to perform an adequate radiological differentiation from other more aggressive lesions such as liposarcomas.

A huge osteolipoma involving the coronoid process: a case report

A 28-year-old man visited our hospital with the chief complaint of trismus. Computed tomography revealed a well-defined, soft tissue tumor, 66 × 45 × 21 mm, with a distinct boundary in the inner region of the zygomatic arch. The mass contained various sizes of bone-like hard tissue, some of which adhered to the right coronoid process. A contrast-enhanced magnetic resonance image showed that the mass was composed mainly of adipose tissue. Tumorectomy was performed, and the histopathological diagnosis was osteolipoma. At 2-year follow-up, mouth opening had increased from 31 mm to 50 mm. (J Oral Sci 58, 141-144, 2016).

Osteolipoma: a rare tumor in the oral cavity

Osteolipoma is a rarely reported histologic variant of lipoma that exhibits bone formation. To the best of our knowledge, only 13 well-documented case reports of osteolipoma in the oral cavity have been published in the English literature. This study presents the clinical, radiographic, and histologic features of an osteolipoma in the oral cavity and reviews the pertinent literature. The patient was a 29-year-old female, who presented with an 8-month history of a painless, progressively enlarging, well-defined, movable submucosal mass in the left posterior buccal mucosa. The lesion had a hard consistency. Imaging findings revealed a spherical radiopacity with an irregular trabecular pattern. The lesion was excised and the diagnosis of osteolipoma was established. No recurrence was observed after a 5-year follow-up.

Osteolipoma in the glabella: pathogenesis associated with mesenchymal lipoma-derived stem cells

Lipoma is a benign tumor that often arises in the craniomaxillofacial region. Osteolipoma containing bone tissue is very rare and the developmental mechanism is unclear. Mesenchymal stem cells in adipose tissue that have potential to differentiate into fat, bone, cartilage, and vascular components may be involved in the development of osteolipoma, in which adipose and bone tissues coexist. We encountered a patient with osteolipoma that arose in the glabella. We describe the case and the results of an investigation of the presence in lipomas of mesenchymal stem cells with differentiation potential similar to that of normal adipose cells. The patient was a 66-year-old woman. Histopathologically, bone tissue surrounded by fibrous connective tissue was present in the nodular adipose tissue and was diagnosed as osteolipoma. Mesenchymal stem cells were collected by collagenase treatment of lipoma tissue, and their potential to differentiate into fat, bone, and cartilage was shown. On the basis of this study, we suggest that lipoma-derived mesenchymal stem cells are the basis of the pathogenesis of osteolipoma. The conditions that induce differentiation of mesenchymal stem cells into bone remain to be investigated.

Osteolipoma of floor of the mouth

Lipomas are benign soft tissue tumours composed mainly of mature adipose tissue. Histological variants of lipomas have been named according to the type of tissue present and they include fibrolipoma, angiolipoma, osteolipoma, chondrolipoma and others. Osteolipoma, a classic lipoma with osseous metaplasia, is a very rare histological variant. Owing to the rarity of oral osteolipomas, we report an uncommon case of osteolipoma located on the floor of the mouth of a 20-year-old female patient and include a review of the literature.

Osteolipoma of floor of the mouth

Lipomas are benign soft tissue tumours composed mainly of mature adipose tissue. Histological variants of lipomas have been named according to the type of tissue present and they include fibrolipoma, angiolipoma, osteolipoma, chondrolipoma and others. Osteolipoma, a classic lipoma with osseous metaplasia, is a very rare histological variant. Owing to the rarity of oral osteolipomas, we report an uncommon case of osteolipoma located on the floor of the mouth of a 20-year-old female patient and include a review of the literature.

Cervical paravertebral osteolipoma: case report and literature review

Lipomas are the most frequent soft tissue tumors. Osteolipomas are a rare variant that can be difficult to diagnose. We report the case of a 66-year-old man consulting with a tumor of 2 years development in the right paravertebral cervical region. Neurologically, the patient had no sign of myelopathy or neurological focality. Magnetic resonance imaging showed a mass with a lipid component and calcifications inside within the right paravertebral musculature with a possible origin in the right C3 posterior root. A computed tomography scan and guided biopsy were performed, revealing hematic material and small bone spicules with no apparent neoplastic element. The tumor was totally removed, including the right C3 posterior branch, and was confirmed to be an osteolipoma on biopsy. The patient remains asymptomatic at 6-month follow-up. The osteolipoma is a benign tumor of soft tissue, characterized by lipoma areas with mature bone tissue differentiation, and even with hematopoietic marrow.

A large parosteal ossifying lipoma of lower limb encircling the femur

Introduction

Lipoma is a benign soft tissue neoplasm that may contain mesenchymal elements, as a result of metaplastic process. Ossification in benign and malignant soft tissue tumors can also manifest due to metaplastic process.

Case presentation

A 45 year old woman presented with a large thigh mass. The mass was developed one and a half year ago which insidiously increased in size and was associated with movement restriction. Radiological findings revealed soft tissue neoplasm on antero-medial aspect of thigh encircling the femur and displacing adjacent muscles. Fine trabeculations were seen in neoplasm suggestive of ossification. Excision of the mass was performed and histopathology revealed adipocytes with mature bony trabeculae possessing prominent osteoblastic rimming suggestive of ossifying lipoma.

Conclusion

It is important to recognize this variant of lipoma as it is associated with a better clinical outcome in contrast to most of the deep seated soft tissue neoplasms. Secondly it should also be differentiated from myositis ossificans and heterologous differentiation in other soft tissue neoplasms. We suggest an algorithmic approach to the diagnosis of ossifying soft tissue neoplasms histopathologically. Mature bony trabeculae with prominent osteoblastic rimming in a soft tissue lesion are due to a metaplastic process and should not be confused with osteosarcoma.

[An unusual location of juxtaosseous ossified lipoma. A case report]

We report a case of juxtaosseous ossified lipoma. Clinical and radiological features make it an exceptional case, because of its location at the hand and presence of cortical erosion of the subjacent bone. However, the histological study of this rare benign tumor showed neither cytonuclear atypia nor increasing number of mitosis. It made easy its surgical treatment, without any functional sequelae. The patient reported no local recurrence in the follow-up; the risk is low, given its histological character.

Osteolipoma of the oral cavity: a case report

BACKGROUND

Osteolipoma located in the oral cavity and pharyngeal region is rare.

CASE REPORT

The current case presents the clinical-ultrasonographic-radiographic-histopathological features of the diagnosis and management of osteolipoma of the mandibular buccal mucosa.

DISCUSSION

A literature review of the osteolipoma of the oral cavity and pharyngeal region is also presented. In this localization study, 14 well-documented cases could be found in English-language literature, in which the mean age of patients was 50.6 years, and slight predilection for male gender could be identified. The majority of cases appeared in the oral cavity (67 %). The data demonstrated that osteolipoma of the oral cavity and pharyngeal region is an asymptomatic (80 %) lesion without bone attachment (80 %). The size of the lesions ranged from 8 to 90 mm in diameter (mean = 36 mm), with an evolution time ranging from 1 to 35 years (mean = 7.7 years). Similar to the present case, no recurrence could be identified in works which reported on the follow-up period.

Osteolipoma presenting as a submandibular mass: a rare presentation

Osteolipomas are rare tumors, particularly in the head and neck region, in contrast to lipomas which are the most common benign neoplasms in this location. Osseous changes are benign and mainly occur in long-standing lipomas. Despite its rarity, this neoplasm has a characteristic histopathologic appearance with lamellar bony spicules within the mature adipose tissue. Of the 19 cases previously reported in the oropharyngeal area, only two were located in the submandibular region. We report the third case of submandibular osteolipoma, presenting as an asymptomatic mass in a middle-aged man. Our review of head and neck osteolipomas would be of particular interest to pathologists and head and neck surgeons, in order to avoid inappropriate treatment of an otherwise benign lesion.

Osteochondrolipoma of the submandibular region: a case report and review of the literature

Lipoma is an extremely common and ubiquitous benign soft tissue tumor composed of mature adipose tissue, with frequent differentiation towards other mesenchymal elements such as blood vessels, fibrous tissue, or muscle. They are typically slow-growing, encapsulated, superficial or deep, and have a wide range in size depending on their location. The presence of cartilage or bone is very rare, with most reported cases in the head and neck area. We report the case of an osteochondrolipoma of the submandibular region with associated benign bone marrow elements, with a review of the literature and discussion of the differential diagnosis.

Rare Lipomatous Tumors with Osseous and/or Chondroid Differentiation in the Oral Cavity Report of Two Cases and Review of the Literature

The purpose of this study was to determine the clinicopathological and immunohistochemical features of lipoma/fibrolipoma with rare occasions as osseous and/or chondroid differentiation in the oral cavity. Two cases of the tumors, who presented with a painless, relatively hard mass on the oral mucosa, were studied. These were consisted of a well-circumscribed mass of fatty tissue with chondroid and significant fibrous component intermixed with the lobules of fat cells with chondroid and woven bone component, respectively. Immunohistochemical study revealed that peripheral spindle cells around chondroid tissue stained diffusely for S-100 α & β and Sox-9, though peripheral spindle cells around osteoid tissue only stained for RUNX-2. According to review of the literature, lipoma/fibrolipoma with osseous and/or chondroid differentiation was 18 cases. Also fibrolipoma with osseous and chondroid differentiation is the first to be reported here. These results indicated that the cartilage/bone is produced by differentiation of undifferentiated mesenchymal cells of stroma.

Ossifying lipoma of the thigh

Lipomas are common soft-tissue tumours that are usually found in the subcutaneous adipose tissue. Occasionally, they may contain mesenchymal elements other than adipose tissue, including osseous components. These ossifying lipomas are usually located near or within bone, and it is very rare for a lipoma with no connection to bone to contain mature osseous tissue. We describe a case of a symptomatic ossifying intramuscular lipoma of the thigh.

Osteolipoma of the oral and pharyngeal region: report of a case and review of the literature

Osteolipoma is an uncommon phenomenon that rarely occurs in the oral and pharyngeal region. A 68-year-old man presented with a 4-year history of a relatively small painless mass in the right mandibular alveolar mucosa adjacent to the premolar teeth. The lesion was easily excised and histologically confirmed to be an osteolipoma. Ten cases of oral and pharyngeal osteolipoma have appeared in the English literature thus far. In addition to reporting a new case of osteolipoma arising in the oral cavity in this article, the literature is reviewed accordingly.

Osteolipoma of the nasopharynx

Osteolipomas of the head and neck are very rare, and there is no reported case of osteolipoma of the nasopharynx in the literature. Here, we present a case of osteolipoma of the nasopharynx in a 21-year-old male who was referred for a nasopharyngeal mass causing a defect in the left half of the soft palate. The well-demarcated, firm tumor was excised through transnasal endoscopic and transpalatal approaches, and the defect of the soft palate was repaired by a superiorly based pharyngeal flap. Osteolipomas should be kept in mind in the differential diagnosis of nasopharyngeal mass as an extremely rare benign lesion.

Subcutaneous ossifying lipoma: case report and review of the literature

BACKGROUND

Lipomas can undergo a variety of changes, one of which is ossification. Ossifying lipoma (OL), independent of bone tissue, is rare. No case has been reported with this heading in the dermatopathological literature.

CASE REPORT

A 73-year-old woman was referred for a subcutaneous mass on the left scapular region that had been present for more than 22 years.

RESULTS

The lesion was an OL measuring 8 cm and weighing 75 g. Only 25 cases of OL have been described in soft tissues. Including the present report, locations in order of frequency are the head and neck area (11 cases), the limbs (9 cases) and the trunk (6 cases). Average patient age is 50.9 years (range, 17-81 years). History is measured in years (mean, more than 6 years). Average tumor size is 7.1 cm (range, 0.8-20 cm). The adipose component is usually predominant and the mature bone tissue is irregular in distribution. Bone spicules are surrounded by fibrous tissue bands. Chondrous structures are found in 46.2% of tumors. No recurrences have been reported.

CONCLUSIONS

OL is rare but has a characteristic gross, radiological and histological appearance. It has the same prognosis as simple lipoma. Excision is the treatment to be chosen.

Osteolipoma arising adjacent to the sternoclavicular joint. A case report

A 45-year-old woman presented with one-year history of a mass on her chest. Computed tomography and magnetic resonance imaging demonstrated a tumour near the sternoclavicular joint. The tumour was diagnosed as osteolipoma histologically after resection. Osteolipoma is a rare tumour and this may be the first report of osteolipoma arising adjacent to the sternoclavicular joint.

Osteolipoma: a rare lesion in the oral cavity

We present the case of a 65-year-old woman who had a painless mass in the left buccal mucosa. Histology showed a benign osteolipoma.

Osteolipoma of the tongue

Lipomas are common, benign tumours located in any part of the body in which fat is normally present. Some variants of lipoma have been described according to the type of tissue present. A rare variant consists of a lipoma with osseous or cartilaginous metaplasia. These lesions have been called chondrolipoma, osteolipoma, lipoma with chondroid or osseous metaplasia, lipoma with cartilaginous or osseous change, or ossifying lipoma. We present the case of an osteolipoma of the tongue in a 49-year-old female who was referred for a painless mass on the left lateral margin of the tongue, and present for about 8 years. Osteolipomas have been reported in middle-aged or elderly patients with a very long clinical history. These tumours tend to be large and to arise from the deep soft or subcutaneous tissues. The cartilage and bone is probably produced by metaplasia of fibroblasts in chondroblasts or osteoblasts. These lesions are benign and do not recur.

Spindle Cell Lipoma of the Parapharyngeal Space: First Report of a Case

Spindle cell lipomas are usually located in the subcutaneous tissue of the back, shoulders, and neck. To our knowledge, the presence of such a tumor in the parapharyngeal space has not yet been described. We evaluated a 45-year-old man with a tender swelling of the right parotid area that had reached the submandibular area. Clinical examination and magnetic resonance imaging revealed the presence of a tumor that coated the parotid area laterally and extended into the center of the parapharyngeal space, thus causing a dislocation of the pharyngeal muscles and mucosa. We performed a total parotidectomy and submandibulectomy on the right side and extirpated the parapharyngeal tumor. We were able to spare the facial nerve, and no facial paralysis occurred. Histologic examination revealed an atypical lipomatous tumor with a remarkably large portion of spindles.