Osteolipoma of tubercinerium: An incidental finding in a patient with schizophrenia.

A 45-year-old male patient with clinically suspected schizophrenia was referred for an MRI brain to look for organicity. An incidental lesion was noted on the right side of the tubercinerium with suspicious findings of osteolipoma. T1 and T2 weighted sequences showed a hyper-intense lesion suggestive of fatty intensity or hemorrhage. A homogenous blooming artefact was seen on gradient imaging suggestive of a calcific/hemorrhagic element. The referring clinician was conveyed the findings asking about the need for further imaging by CT. The patient was started on antipsychotics for schizophrenia. One week later, a CT head was obtained, which showed a fatty density lesion with a smooth, peripheral rim of hyperdensity. The HU value matched rim calcification suggesting radiological diagnosis of osteolipoma. The patient was kept under close observation and no specific therapy was guided to this lesion. The patient was responding well to pharmacotherapy (in terms of control of symptoms) confirming osteolipoma as an incidental finding. This case report establishes the role of adequate imaging in subtle brain lesions which may mimic primary lesion-producing neurological symptoms. The importance of clinical judgment and follow-up in guiding suitable therapy is also highlighted.

Parosteal Osteolipoma in the External Auditory Canal: A Rare Variant of Lipoma.

Osteolipomas are a rare variant of lipomas. We present a case of osteolipoma of external audiotry canal in a 30 year old lady who presented with right sided ear fullness since 2 years. A well circumscribed mass was found arising from right bony external audiotry canal. Computed tomography revealed a calcified lesion measuring 9 × 7 mm in the cartilaginous portion of right external auditory canal. Diagnosis of Osteolipomas was made histologically and patient was treated with simple excision of the mass under local anaesthesia.

Osteolipoma of head and neck - a review

Abstract 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.

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.

Osteolipoma of the ankle: A rare case report.

Osteolipoma are uncommon benign soft tissue tumors, deriving from fat cells metaplasia. We report a case of 47-year-old female with a progressively enlarging, painless mass over the anteromedial aspect of left ankle, explorations showed a calcified masse and histopathologic diagnosis was in favor of osteolipoma, which was resected surgically without any recurrence after 2 years follow up. This tumor can affect different regions of the body but ankle location is very rare and must be distinguished from other diagnosis essentially sarcoma.

Osteochondrolipoma of the Hand.

Lipoma is the most common type of benign soft tissue tumor and is composed of mature adipose tissue. A neoplasm of adipose tissue with admixed mature bone and cartilage, or osteochondrolipoma, is an extremely rare histologic variant. Most documented osteochondrolipomas have occurred in the soft tissues of the head and neck related to the oral cavity, and the tumor is seen involving the extremities. A fatty mass with nonlipomatous elements can present a diagnostic challenge. We present a rare case of osteochondrolipoma involving the wrist. The clinical presentation, radiographic images, histologic findings, and treatment are discussed in this case report.

Osteolipoma: a review of the literature and a rare case report.

OBJECTIVES: Lipomas are the most common benign mesenchymal tumors of soft tissue. According to previous studies, 1-4% of the cases has been observed in the oral cavity. A histological variant of lipoma featuring bone formation is called osteolipoma and has been very rarely observed (less than 1% of the total). In order to make a meaningful addition to this rare knowledge base, our study aims to provide a literature review and to report an additional case of osteolipoma. METHODS: An electronic search in the PubMed database with the keyword "osteolipoma" was conducted. Among 69 search results, only the cases of osteolipoma located in the "oral cavity" were included in this study. The findings of the previously reported 20 cases (in English) of osteolipoma of the oral cavity were organized in a table along with a new case of osteolipoma located in the mandibular buccal vestibule with radiological and histopathological findings provided by the authors. RESULTS: Osteolipoma affects both sexes and usually emerges in middle-aged or elderly patients with a long history of slow progression. Different imaging techniques may be utilized in the radiographic evaluation. CONCLUSION: Differential diagnosis includes a wide range of lesions; therefore, the clinical and radiographic evaluation should be confirmed by histopathological examination. The suggested treatment is complete surgical excision and follow-up, and the prognosis is generally good.

Adipocytic tumors of orofacial region: Clinicopathologic appraisal of ten cases with a review of its variants.

Lipomas are the most common benign tumors. However, their presence in oral cavity is albeit erratic. Even scarcer is the prevalence of the various histopathological variants. We, hereby, report the wide range of clinical and histopathologic presentations of these uncommon entities affecting the orofacial region. Discussed herein are six cases of lipomas, two cases of intramuscular lipomas and one case each of osteolipoma and sialolipoma.

A rare intramuscular osteolipoma: A case report.

INTRODUCTION: Lipomas are frequently presented in adults and account for almost 50% of all soft-tissue tumors. Osteolipomas are rare and usually located in the intraosseous region or adjacent to bone. It is very unusual for osteolipomas with no connection to bony structures. We report a rare intramuscular osteolipoma independent of bone tissue. PRESENTATION OF CASE: We report a case of a 58-year-old man with painful and progressively enlarging mass in the right lower leg. A plain X-ray and computed tomography (CT) scans revealed a large homogeneous, low-fat density mass containing an oval shape calcification without bone connection. MRI showed a circumscribed mass in the peroneus muscle with a large calcified component. The patient underwent surgical excision of the mass. Histologically, benign osteolipoma was the final diagnosis. No recurrence was observed at six months follow-up. DISCUSSION: Lipoma is a common benign soft tissue neoplasm but osteolipoma is rare. Most cases osteolipomas are connected with bone. independent of bone tissue has been reported in very few cases. Most of them occurred in the head and neck area. The pathogenesis of osteolipoma is still not clear. Although CT and MRI are useful for differential diagnosis, care should be taken because sometimes they are indistinguishable from well-differentiated liposarcomas. Excisional biopsy is useful for definitive diagnosis. CONCLUSION: Although ossifying lipomas are very rare, it is important to keep them in mind when a lesion with adipose tissue in combination with ossification is encountered.

Osteolipoma in the Forearm.

A case of left distal forearm and wrist osteolipoma in a 56 year old female is reported. The patient presented with a 3 year history of nontender left wrist mass. Radiographs demonstrated a lobulated mass of mixed low density and calcifications, not adjacent to and with no connection to underlying bone. Ultrasound showed a spheroid hyperechoic lesion with internal heterogeneity and rim of calcifications. Magnetic resonance imaging revealed a lesion with predominantly fat characteristics on T1 weighted and T2 weighted sequences, with rim of peripheral calcification and specks of internal calcification. Histological examination after excision of the mass showed the lesion to be an osteolipoma. Osteolipoma is a rare variant of lipoma with osseous metaplasia and should be considered in the differential of a fat containing mass with ossification.

Giant Osteolipoma Fixed to the Greater Trochanter of the Femur in a Seventy-Year-Old Elderly Woman.

A lipoma containing mature osseous elements is called osteolipoma. This article describes a giant osteolipoma fixed to the periosteum of the greater trochanter of the femur. A seventy-year-old woman presented with a large subcutaneous mass in the right buttock which had been present for six years. On local examination, a giant mass that was ovoid, firm, non-tender, well demarcated, subcutaneous, and relatively fixed to the greater trochanter was palpated in the right buttock. A medical imaging and fluoro-deoxy-glucose (FDG) bone scan revealed a large lipomatous and metabolically active lesion arising from the periosteum of the greater trochanter of femur. The excisional mass of 17 × 8 × 7 cm3 was well encapsulated and had an osseous basal portion. Cut sections of the mass revealed mainly yellow fatty tissue surrounded by a thin fibrous capsule with numerous interlacing thin lamellar bony structures. The definitive pathological diagnosis was osteolipoma without evidence of malignancy. No recurrence was observed at eight months follow-up. Osteolipoma with an osseous basal portion is rare. Surgical excision is the treatment of choice and the prognosis is good. To the best of our knowledge, this is the first report of an unusual giant osteolipoma fixed to the periosteum of the greater trochanter of the femur.

Osteolipoma of the knee.

A case of a right knee intra-articular osteolipoma in a 64-year-old man is reported. The patient presented for evaluation of a 1-year history of nontraumatic, mechanically-exacerbated, medial-sided right knee pain. Radiographs demonstrated a partially calcified 3.0 cm mass anterior to the distal medial femur at the suprapatellar fossa. Magnetic resonance imaging examination confirmed a 4.0 × 3.6 cm well-circumscribed mass deep to the medial patellofemoral ligament, with predominantly fat characteristics on T1-weighted and T2-weighted sequences. The mass had irregular ossification superiorly with surrounding heterogeneous enhancement. Histologic examination of an excisional biopsy showed the lesion to be an osteolipoma. Osteolipoma is a rare histologic variant of lipoma with osseous metaplasia, but should be considered in the differential of a fat-containing neoplasm with ossification.

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.

Isolated dorsal column dysfunction due to an intraspinal Osteolipoma - Case report and review of literature.

Osteolipoma is a rare variant of the ubiquitous lipoma. Published literature appears in the form of isolated case reports affecting soft tissue structures in the head, neck and rarely affecting the spine. We present a unique instance of an intraspinal osteolipoma in the cervical spine, without evidence of accompanying spinal dysraphism and an atypical clinical presentation of isolated dorsal column dysfunction. We describe the clinical presentation, operative procedure and post-operative outcomes with histopathological findings of this rare entity. A 61-year-old male presented with impaired dorsal column sensation due to an intraspinal extradural ossifying lesion in the cervical spinal canal. The patient underwent excision of the lesion with complete resolution of symptoms. Ossifying lesion in the spinal canal may be frequent finding on radiological imaging but presence of possible adipose tissue in the lesion should raise suspicion of rare clinical scenario of an osteolipoma.

Intracranial interhemispheric osteochondrolipoma: Diagnostic and surgical challenges in an extremely rare entity.

Intracranial lipomas are rare developmental lesions, predominantly occurring in the interhemispheric location. Osteochondrolipoma is an extremely rare variant of lipoma with osseous and chondroid differentiation. We present a case of interhemispheric osteochondrolipoma, in a 2.5-years-old male child which was detected antenatally, in association with corpus callosum agenesis. The lesion progressively increased in size with resulting compression of surrounding structures, and was subjected to microsurgical decompression. To the best of our knowledge, this is the first case of intracranial interhemispheric osteochondrolipoma in the existing medical literature. Peculiarities of this case and the diagnostic and surgical challenges are discussed.

Osteolipoma in the retromolar trigone: A case report and review of literature.

Osteolipoma is the distinct histological variant of lipoma. Until now, a total of 17 cases have been documented in English literature. It is most commonly seen in buccal mucosa, floor of the mouth, tongue, palate, and parapharyngeal spaces of the oropharyngeal region. The aim of the present communication is to report an unusual presentation of osteolipoma in the retromolar trigone. Conventional radiographs have revealed "whorled pattern" of radiographic appearance in our case that might be due to uniform distribution of bony trabeculae within tumor; such type of finding has not been reported till now. Hence, here, we add these new features to existing literature.

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.

Symptomatic osteolipoma of the tuber cinereum masquerading as calcified retroclival mass.

We present a case of symptomatic osteolipoma of the tuber cinereum in a 51 year old male with rapid visual deterioration over several months leading to bilateral visual loss. Preoperatively the lesion masqueraded as a calcified retroclival mass. Intracranial osteolipomas are rare benign lesions that are usually asymptomatic and have an indolent course. Additionally, we discuss our intraoperative findings highlighting the technical challenges encountered along with a review of the English language literature on histologically proven intracranial osteolipomas.

Infiltrating hybrid mesenchymal tumor of skeletal muscle showing lipomatous, hemangiomatous, leiomyomatous and osseous features - An unusual soft tissue tumor providing insight into the pathogenesis of lipoma variants.

Infiltrating angiolipoma and osteolipoma of the hand are rare. A 40-year-old man presented with slowly enlarging swelling of his right hand for two and half years without functional deficit but it became painful with slight limitation of movement for the past few months. Plain radiograph showed a large soft tissue swelling with specks of calcifications. Ultrasonography and magnetic resonance imaging revealed an infiltrative mass in the right palm deep to the flexor tendons. As biopsy suggested infiltrative angiolipoma of skeletal muscle, debulking of the tumor was performed. The tumor showed coexistence of all four mesenchymal elements, fat, blood vessel, smooth muscle and bone in various combinations in the form of angiolipomatous, osteolipomatous, ossified intramuscular hemangiomatous, myolipomatous and angiomyolipomatous patterns throughout the entire tumor. Small meningothelial-like whorls of spindle cells were focally seen, some showed intramembranous ossification forming small woven bony spicules in their centers. There were no atypical cells or lipoblasts. Staining for CDK4, MDM2, p16, HMB45 and Melan A was negative. The diagnosis was "infiltrating hybrid mesenchymal tumor of skeletal muscle showing lipomatous, hemangiomatous, leiomyomatous and osseous features". The fairly even admixture of the various components supports the neoplastic participation of each individual element. Hybrid mesenchymal tumor most probably originates from multipotent neoplastic cells showing multidirectional differentiation.

Pure intramuscular osteolipoma.

Ossified lipoma or osteolipoma are rarely reported. It is defined as a histologic variant of lipoma that has undergone osseous metaplasia. Osteolipoma presents with a dominant osseous component within a lipoma. We report a case of a histologically confirmed osteolipoma on the nuchal ligament independent of bone. The patient was a 51-year-old female who presented with a 5-year history of a painless, progressively enlarging mass on the posterior neck. Computed tomography and magnetic resonance imaging showed a circumscribed mass compatible with fat between the C2 and C6 spinous processes with a large calcified irregular component. The mass with dual components was totally removed under general anesthesia and no recurrence was observed after 6 months of follow-up. We also reviewed the clinicopathologic features of previously reported osteolipomas in the literature and suggest that although osteolipoma is a rare variant of lipoma, it should be considered in the differential diagnosis when a lipoma of the posterior neck mixed with a bony component is encountered.