Surgical removal of maxillary osteolipoma through Le Fort I osteotomy: Case report and literature review

Authors

DOI:

https://doi.org/10.33448/rsd-v14i2.48196

Keywords:

Lipoma; Maxillary osteotomy; Le Fort osteotomy; Maxillofacial surgery; Head and neck.

Abstract

Osteolipomas consist of a metaplastic variation of lipoma, which are considered very rare when presented in an intraosseous location in the head and neck region. They usually present as a painless, slow-growing mass that, when properly diagnosed and treated, have a satisfactory prognosis and low recurrence rates. This paper aims to report the case of a 49-year-old female patient, who attended the clinic complaining of a painless lesion in the maxilla, discovered through a panoramic radiograph performed for orthodontic documentation purposes. Imaging exams showed a well-defined irregular mass, moderately calcified with a heterogeneous appearance, projecting from the inner cortex of the anterior wall of the left maxilla into the ipsilateral maxillary sinus, with its central portion hypodense and surrounded by tissue of greater hyperdensity. After performing an incisional biopsy and obtaining a pathological result of osteolipoma, resection of the lesion was scheduled in a hospital setting using the Le Fort I osteotomy technique. The material was again sent for histopathological analysis, confirming the previous diagnosis. Under 12 months of postoperative follow-up, the patient showed no complaints or clinical and radiographic signs of lesion recurrence. The correct prior diagnosis is significant for choosing the best approach for the definitive treatment of lesions. The use of Le Fort I osteotomy not only allowed direct visualization of the involved area, facilitating complete removal of the lesion, but also avoided unnecessary destruction of the maxilla structure.

References

Abdalla, W. M., Da Motta, A. C., Lin, S. Y., McCarthy, E. F., & Zinreich, S. J. (2007). Intraosseous lipoma of the left frontoethmoidal sinuses and nasal cavity. AJNR American Journal of Neuroradiology, 28(4), 615-617.

Adebiyi, K. E., Ugboko, V. I., Maaji, S. M., & Ndubuizu, G. T. U. (2011). Osteolipoma of the palate: Report of a case and review of the literature. National Library of Medicine, 14, 242-244.

Bowers, I. D., Imlay, S. P., Schroeder, N., & Bahu, S. J. (2020). Retropharyngeal osteolipoma requiring an interdisciplinary approach. Ear, Nose & Throat Journal, 99(10), 1-5.

Castilho, R. M., Quadraturo, C. H., Nunes, F. D., & Pinto, J. R. (2004). Osteolipoma: Uma lesão rara na cavidade oral. Revista Britânica de Cirurgia Oral e Maxilofacial, 42, 363-364.

Drommer, R. B. (1986). The history of the “Le Fort I osteotomy”. Journal of Maxillofacial Surgery, 14, 119-122.

Durmaz, A., Tosun, F., Kurt, B., Gerek, M., & Birken, H. (2009). Osteolipoma of the nasopharynx. European Archives of Oto-Rhino-Laryngology, 266(2), 267-270.

Dutescu, N., Georgescu, L., & Hary, M. (1973). Lipoma of submandibular space with osseous metaplasia. Oral Surgery, 35, 611-615.

Firth, N. A., Allsobrook, O. F. L., & Patel, M. (2017). Osteolipoma of the buccal mucosa: A case report. Australian Dental Journal, 65(4), 537-542.

Fregnani, E. R., Pires, F. R., Falzoni, R., Lopes, M. A., & Vargas, P. A. (2003). Lipomas of the oral cavity: Clinical findings, histological classification and proliferative activity of 46 cases. International Journal of Oral and Maxillofacial Surgery, 32, 49-53.

Hoffman, G. R., & Islam, S. (2008). The difficult Le Fort I osteotomy and downfracture: A review with consideration given to an atypical maxillary morphology. Journal of Plastic, Reconstructive & Aesthetic Surgery, 61, 1029-1033.

Karabas, H. C., Ozcan, I., Soluk Tekkesin, M., & Isler, S. C. (2021). Osteolipoma: A review of the literature and a rare case report. Oral Radiology, 37(1), 42-49.

Korpi, J. T., et al. (2009). Removal of large complex odontoma using Le Fort I osteotomy. Journal of Oral and Maxillofacial Surgery, 67(9), 2018-2021.

Laureano Filho, J. R., Câncio, A. V., Mauricio, H. A., Lima, F. F., & Pinho Filho, J. (2004). Le Fort I osteotomy in an intra-oral surgical approach to excision of juvenile nasopharyngeal angiofibroma: A case report. Revista de Cirurgia e Traumatologia Buco-Maxilo-Facial, 4(4), 229-236.

Leite Segundo, A. V., Bozzetto-Ambrosi, P., Cauas, M., Caubi, A. F., & Azevedo Filho, H. R. C. (2007). Le Fort I osteotomy as a surgical approach to skull base epidermoid carcinoma. Revista de Cirurgia e Traumatologia Buco-Maxilo-Facial, 7(2), 55-60.

Morais, H. G. de F., et al. (2023). A 14-year retrospective study focusing on clinical and morphological features of oral cavity lipomas: A review of main topics. Journal of Stomatology, Oral and Maxillofacial Surgery, 124(3), 101387.

Ohno, Y., Muraoka, M., Ohashi, Y., Nakai, Y., & Wakasa, K. (1998). Osteolipoma in the parapharyngeal space. European Archives of Otorhinolaryngology, 255, 315-317.

Omonte, S. V., Andrade, B. A. B., Leal, R. M., Capistrano, H. M., Souza, P. E. A., Horta, M. C. R. (2015). Osteolipoma: A rare tumor in the oral cavity. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 122, 8-13.

Pereira A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Santa Maria/RS. Ed. UAB/NTE/UFSM

Raghunath, V., & Sharanesha Manjunath, B. (2015). Osteolipoma of floor of the mouth. BMJ Case Reports.

Raviraj, J., Kumar-Bokkasam, V., Suresh, D., & Venkata, S. (2016). Osteolipoma of buccal mucosa: Case report and literature review. Journal of Clinical and Experimental Dentistry, 8(2), e214-e218. https://doi.org/10.4317/jced.52803

Saghafi, S., Mellati, E., Sohrabi, M., Raahpeyma, A., Salehinejad, J., & Zare-Mahmoodabadi, R. (2008). Osteolipoma of the oral and pharyngeal region: Report of a case and review of the literature. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, 105(4), 471-475. https://doi.org/10.1016/j.tripleo.2008.02.018

Soares, E. C. S., Medeiros, J. R., Bezerra, T. P., Nogueira, C. B. P., Costa, F. W. G., & Nogueira, A. S. (2013). The use of Le Fort I approach in the resection of an extensive ossifying fibroma. Oral and Maxillofacial Surgery, 17, 209-212. https://doi.org/10.1007/s10006-012-0358-1. Disponível em:

Weiss, S. W., & Goldblum, J. R. (2001). Benign lipomatous tumors. In F. M. Enzinger & S. W. Weiss (Eds.), Enzinger and Weiss’s soft tissue tumors (4th ed., pp. 574-581). Mosby.

Published

17/02/2025

How to Cite

NASCIMENTO, A. C. C. do .; ORELLANA MARTÍNEZ, F. E.; CAVALCANTE, V. F.; QUEIROZ, E. da C.; MOTA, M. R. L. .; ALVES, A. P. N. N. .; SOARES, E. C. S. Surgical removal of maxillary osteolipoma through Le Fort I osteotomy: Case report and literature review . Research, Society and Development, [S. l.], v. 14, n. 2, p. e5814248196, 2025. DOI: 10.33448/rsd-v14i2.48196. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/48196. Acesso em: 30 mar. 2025.

Issue

Section

Health Sciences