Chondroid lipoma: a rare but diagnostically important lesion

Chondroid lipoma is a rare benign fatty tumour that has been confused with liposarcoma and chondrosarcoma. We present a case in a 44-year-old man and highlight the features that differentiate this benign lesion from the more aggressive ones.     

Intraosseous lipoma in the periapical region of a maxillary third molar

Introduction

Images of oral lesions can look so exceptionally similar that a diagnosis hypothesis could be difficult. Lesions mimicking apical periodontitis must be considered when making a differential diagnosis. Intraosseous lipoma is a rare benign tumor of low incidence among all bone tumors, and therefore few cases have been reported in the literature.

Methods and Results

A case of intraosseous lipoma associated with the distobuccal root of tooth #1 in a 39-year-old woman is described. The dental general practitioner did not perceive anything of note in terms of the radiographic aspect, so consequently the periapical lesion went unnoticed. However, after tooth extraction, a different feature was noticed in the surgical specimen. The lesion associated to the roots of tooth #1 was surrounded by soft tissue forming a fibrous capsule (10 mm in diameter). A histopathologic examination showed an area of bone of lamellar aspect surrounding a central area of fat tissue diagnosed as intraosseous lipoma. This type of lesion is asymptomatic, and its etiology is unclear.

Conclusions

Intraosseous lipoma should be considered in the differential diagnosis of other jaw lesions. A histologic examination is mandatory for the diagnosis, because this lesion is characterized by bone of lamellar aspect surrounding a central area of fat tissue. The treatment chosen in this case was surgical excision, and the outcome was favorable.     

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

Intraosseous lipoma is a benign tumor of the bone. It is mostly seen in the metaphyses of the long bones and calcaneus. There are few documented cases of intraosseous lipomas in the jaw. Clinically, the lesion is usually silent and radiologically it appears as a radiolucent area rarely including some radio-opacities. Diagnosis is based on clinical, radiological and histopathological features. Surgical removal of the lesion is the recommended treatment. The authors report a rare case of an intraosseous mandibular lipoma in a 45-year-old female, and review previously documented cases in the English literature. The histopathological and radiological features of the lesion are emphasized.     

Spindle cell lipoma of the oral cavity: report of a case

A true lipoma is an uncommon lesion intraorally and the spindle cell variant is extremely rare, with only four cases reported in the English language literature. A new case of spindle cell lipoma affecting the tongue of a 68-year old white woman is reported.     

Retropharyngeal lipoma presenting with snoring in a child

Retropharyngeal lipoma in a child is an extremely rare pathological entity. The unusual case of a child with a retropharyngeal lipoma presenting with snoring is reported. Retropharyngeal lipoma should be considered in the differential diagnosis of snoring in children.     

Osteolipoma: a painless mandibular mass

Lipoma is the most common benign mesenchymal soft tissue neoplasm in adults. It is rarely seen in the oral cavity and comprises 1–4% of all benign oral lesions. There are different types of lipomatous tumors that contain other predominant mesenchymal elements such as cartilaginous/osseous tissues. Osteolipoma is a rare histopathologic variant of lipoma accounting for less than 1% of all lipomatous cases. Eight cases of this type of lipoma were reported in the mandibular buccal vestibule. The present study aims to report a rare condition: a patient with osteolipoma situated in the mandibular region. In addition, a literature review is presented.     

颈深部脂肪瘤1例

脂肪瘤是一种常见的来源于间叶组织的良性肿瘤,但临床上极少发生于颈部深层组织内。本文报道1例累及硬膜外隙的颈深部脂肪瘤,并结合文献对其发病情况、组织来源、诊断及治疗等进行讨论。     

腮腺脂肪瘤17例临床回顾分析

目的 总结腮腺脂肪瘤的临床表现及治疗效果。方法 回顾分析17例腮腺脂肪瘤患者病史、临床表现、影像学检查、治疗方案及预后情况。结果 17例腮腺脂肪瘤均位于腮腺浅叶,表现为腮腺区无痛性肿块;男11例、女6例;年龄33~76岁,平均50.7岁。超声检查见腮腺内边界清晰低回声区,CT检查提示腮腺内包膜完整低脂密度肿物。在正常腮腺组织内完整切除肿瘤,术后无面神经麻痹等并发症,随访无复发。结论 腮腺脂肪瘤中年男性多见,常表现为腮腺内无痛渐大质中软肿物,行功能性腮腺部分切除术,预后良好。     

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咽旁间隙肿瘤仅约占头颈部肿瘤的0.5%[1]。其中咽旁间隙脂肪瘤更为罕见,目前文献均为个案报道。青岛大学医学院附属医院口腔颌面外科2005—2009年共收治该病患者4例。现报道如下并结合相关文献进行分析。     

Sialolipoma of the hard palate

Sialolipoma is a new variant of salivary gland lipoma, which was first proposed by Nagao et al. (Histopathology 2001; 38: 30) in 2001. We report this rare case of sialolipoma in the hard palate. A 60-year-old Japanese woman was referred to our department complaining of a painless swelling on the right side of the hard palate. Intra-oral examination revealed a soft, elastic, dome-shaped mass with 1 cm in diameter located in the posterior part of the hard palate. Magnetic resonance imaging examination revealed high intensity on T(1)-weighted image and isointensity on T(2)-weighted image. Incisional biopsy revealed that the tumor was encapsulated by fibrous tissue, consisted of adipose tissue, and also contained normal salivary gland tissue peripherally. First diagnosed as an ordinary lipoma of the hard palate, the tumor was excised. According to the recent criteria of histologic findings of sialolipoma, we rediagnosed the tumor as sialolipoma of the hard palate.     

19例颌面部脂肪瘤临床分析与文献复习

目的 探讨颌面部脂肪瘤的临床特征、早期诊断及治疗方法,以期提高对该病的认识,减少误诊和漏诊。 方法 回顾性分析19例经病理诊断为颌面部脂肪瘤的病例资料,复习相关文献。 结果 发病年龄以60岁以上老年人居多,其次为60岁以下的成年人,极少发生于未成年人;发病性别无明显差别;发病的组织层次以皮下和黏膜下层最多,其次为涎腺内、黏膜表面和肌肉内,颌骨和深部间隙极少;临床表现均无明显特异性临床症状,以偶然发现为主,术前多数可以行彩超、CT等检查确诊,最终确诊均靠病理;肿瘤大小不一,一般有完整的或不完整的包膜,与周围正常组织分界清晰,容易分离,能够完整切除,且无复发。 结论 彩超、CT和MRI检查可以初步明确颌面部脂肪瘤的术前诊断,确诊靠术后病理。治疗以手术切除为主,手术较彻底且不易复发。     

Atypical lipomatous tumor of the lip with pleomorphic lipoma-like myxoid area, clinically simulating mucocele

Lipomatous tumor is least common in the oral cavity. We present a case of atypical lipomatous tumor arising in the lower lip of an 81-year-old male. Clinical diagnosis was mucocele. The tumor measured 12 mm in diameter with a round shape. It was solid, firm, myxomatous and translucent with a small yellowish focus in the central portion. Histologically, the tumor was a circumscribed and well-encapsulated mass with prominent myxoid matrix. The central minor portion showed a well-differentiated liposarcoma. In the myxoid area, lipoblasts and large atypical cells with dense chromatin including floret-like giant cells were seen in abundance. Atypical lipomatous tumor may be indistinguishable from pleomorphic lipoma and its distinction from the latter is based on location as well as relative abundance of floret-type giant cells and lipoblasts. According to its abundance in lipoblasts over floret-like cells, pleomorphic lipoma-like area in our case could also be a part of atypical lipomatous tumor. It may be possible to interpret myxoid change in our case as to represent a superficial counterpart of myxoid malignant fibrous histiocytoma-like change reported in the retroperitoneal lesion.     

Intramuscular lipoma in the masseter muscle: a case report

This is the first report to our knowledge of an intramuscular lipoma that arose in the masseter muscle. Excision biopsy under general anaesthesia showed that the mass could easily be separated from the surrounding soft tissues on the lateral side, but was firmly adherent to the muscle on the medial side, so complete excision required resection of part of the masseter. Histopathological examination showed that it was an intramuscular lipoma. Two years and 6 months postoperatively there was no evidence of recurrence.     

Angiofibrolipoma of the oral cavity

We describe an unusual and rare case of a lipoma variant known as angiofibrolipoma. A literature search revealed only a few cases of angiofibrolipoma which were located in different anatomical sites; no case of angiofibrolipoma in the oral cavity has been previously reported. We present and discuss the histopatholological–immunohistological findings and features. Angiofibrolipoma histologically consists of mature adipocytes, blood vessels, and bundles of collagenous connective tissue with low to moderate cellularity. It is not encapsulated, but is histologically distinct from surrounding tissue. Positive immunohistological staining with CD‐34 presented a large number of blood vessels of different sizes located between collagen fibers and adipocytes. The treatment of choice for a patient with angiofibrolipoma is surgical excision, which is expected to be curative.     

Island of salivary gland in adipose tissue: a report of three cases

Although uncommon, many variants of lipomatous lesions in or around salivary glands have been reported in the literature. We report a series of three such cases in the minor salivary gland region. The first case (oral floor) is a well-circumscribed lipocytic lesion admixed with glandular components (mucous acini, serous demilunes and ducts). The second case (alveolar mucosa) is a diffuse lipomatous proliferation with entrapped salivary glandular elements, muscles and blood vessels. The third case (palate) is similar to the first case but the gland is located at the periphery of the lesion. The purpose of the article was to report these three lesions and discuss in relation to other pertaining lipomatous lesions (sialolipoma, lipoadenoma, lipomatosis, lipometaplasia in pleomorphic adenoma and infiltrating lipoma).     

Pleomorphic lipoma of the face: case report

Pleomorphic lipoma is an uncommon variant of lipoma, which microscopically may resemble a liposarcoma. However, it is a slow-growing and well-circumscribed lesion with a benign behavior. Therefore, recognizing this entity is extremely important to perform the proper treatment. We present an additional case of pleomorphic lipoma in the face, which to our knowledge seems to be the 11th case reported in the English-language literature.     

Osteolipoma of the buccal mucosa: a case report

Lipomas are benign mesenchymal neoplasms of soft tissue that can be found commonly in any part of the human body. Their presence in the oral mucosa is uncommon, however, with approximately 4% of the cases occurring in the oral cavity. Oral lipomas are likely to have originated from mature adipose tissue and there are several histological variants of lipomas described, which are identified according to the predominant type of tissue in addition to adipose tissue. A rare lipoma variant, known as an osteolipoma or an ossifying lipoma, may occur; however, little has been written this type of lipoma characterized by a classical lipoma with areas of osseous metaplasia. This paper describes a case of an osteolipoma involving the buccal mucosa of an adult patient.     

Transoral robotic surgery of parapharyngeal space tumours: a series of four cases

Tumours arising from the parapharyngeal space (PPS) represent less than 1% of all head and neck tumours. Salivary gland tumours account for 40–50% of PPS lesions and are located in the pre-styloid parapharyngeal space. Pleomorphic adenomas represent 80–90% of salivary tumours in the PPS. Recently, transoral robotic surgery (TORS) has become common in head and neck surgery as a minimally invasive procedure. Four cases of benign PPS tumour treated with TORS are presented here. Preoperative diagnosis was conducted by fine needle aspiration biopsy and magnetic resonance imaging, and the results were used to plan the correct surgical approach. One case required a change of approach to conventional transoral blunt dissection. Patients required pain control and reported dysphagia symptoms for a period of weeks, but no nasogastric tube was needed at any time. This case series indicates that TORS is a safe surgical procedure for the excision of benign tumours of the PPS in selected cases.