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CASE REPORT Table of Contents   
Year : 2002  |  Volume : 12  |  Issue : 1  |  Page : 79-80
Osteolipoma


Department of Radio Diagnosis and Imaging, Kasturba Medical College, Manipal, Karnataka, India

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Keywords: Osteolipoma, Computed Tomography

How to cite this article:
Shetty D, Lakhkar B. Osteolipoma. Indian J Radiol Imaging 2002;12:79-80

How to cite this URL:
Shetty D, Lakhkar B. Osteolipoma. Indian J Radiol Imaging [serial online] 2002 [cited 2019 Jul 17];12:79-80. Available from: http://www.ijri.org/text.asp?2002/12/1/79/28422

   Introduction Top


Osteolipomas occur due to osseous metaplasia in lipoma and is mainly encountered in lipomas of large size and long standing duration.1 They have been reported commonly in intracranial sites such as suprasellar, interpeduncular and quadrigeminal cisterns. However, extracranial soft tissue adipose tumors containing osseous elements are extremely rare and only one case has been reported by Ohno et al2 in the parapharyngeal space.

We would like to report a rare case of osteolipoma in the right parapharyngeal space detected on Computed Tomography (CT) and confirmed by surgical resection.


   Case Report Top


A 17 year old woman presented with difficulty in swallowing of one year duration. She also complained of decreased hearing and tinnitus in the right ear. General examination did not reveal any abnormality. Blood parameters and peripheral smear were normal. On local examination there was fullness of the right side of the face and oral examination revealed the right tonsil and soft palate to be pushed medially.

CT of the base of the skull revealed a right parapharyngeal mass, which was compressing the oropharynx and carotid vessels. The Hounsfield values of the lesion revealed osseous and lipomatous components [Figure - 1]. A CT diagnosis of an ossified lipoma was considered.

The tumor was excised through right transmandibular transcervical approach. Biopsy report of the tumour specimen after decalcification was confirmed to be osteolipoma.


   Discussion Top


Lipomas consisting of mature fat grow insidiously, they are asymptomatic and thus reach large size to cause cosmetic complications because of their anatomic site. Lipoma is rare during the first two decades of life and usually makes its appearance when fat begins to accumulate in an active individual. Two types of lipomas can be distinguished, namely subcutaneous and deep. The deep lipomas occur in varying locations such as forehead, scalp, chest wall, pleura, pelvis and retroperitoneum3. When they are of long standing duration, growth in size and osseous metaplasia of lipoma has been observed1.

Osteolipomas have commonly been reported in intracranial sites such as suprasellar, interpeduncular and quadrigeminal cisterns4. These lipomas in contrast to lipomas at other intracranial sites contain a peripheral ossified component5. Compared to intracranial lipomas, ossification of extracranial lipomas is even more rare. Among a series of 635 extracranial, soft tissue tumors differentiating as adipose tissue, none contained osseous tissue6. Ohno et al have reported a single case of osteolipoma in the parapharyngeal space2.

CT scans permit excellent evaluation of calcified or ossified components of lipoma7. Because its clinical course is generally benign, an asymptomatic osteolipoma can be managed without surgery when the diagnosis is established on radiologic grounds. When the lesion becomes symptomatic or diagnosis is in question, excision of the lesion is mandatory. In our case though the CT diagnosis was confirmatory of an osteolipoma, excision was mandatory because of the clinical presentation by the patient[7].

 
   References Top

1.Murphy NG: Ossifying lipoma. Br J Radiol 1974; 47:97  Back to cited text no. 1    
2.Ohno Y, Muraoko M, Ohashi Y, Nakai Y, Wakara K: Osteolipoma in the parapharyngeal space. Eur Ach Otorhino laryngol 1998; 255(6) : 315-317.  Back to cited text no. 2    
3.De Weerd JH, Dockerty MB: Lipomatous retroperitoneal tunmors. Am J Surg 1952; 84: 397  Back to cited text no. 3    
4.Truwitz CL, Barkowich AJ: Pathogenesis of intracranial lipoma: a MR study in 42 patients. Am J Roentgenol 1990; 155:855-864  Back to cited text no. 4    
5.Wickremesekera AC, Christie M, Marks PV: Ossified Lipoma of the interpeduncular fossa: a case report and review of the literature. Brit J Neurosurg 1993; 7:323-326.  Back to cited text no. 5    
6.Allen PW: Tumours and proliferations of adipose tissue. In : Sternberg SS, ed. Masson Monographs in diagnostic pathology. New York: Masson publishing USA, 1981.  Back to cited text no. 6    
7.Kikuchi K, kowada M, Watanabe K: Computed tomography of an intracranial lipoma confined in the suprasellar cistern. Comp Med Imag Graph 1994; 18: 187-192.  Back to cited text no. 7    

Top
Correspondence Address:
D Shetty
Department of Radio Diagnosis and Imaging, Kasturba Medical College, Manipal, Karnataka
India
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Source of Support: None, Conflict of Interest: None


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    Figures

[Figure - 1]

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    Introduction
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