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.

KEYWORDS
Osteolipoma; Head and neck; Radiology; Histopathology

HIGHLIGHTS

80% of the patients with osteolipoma presented with a painless mass which had pre-existed for at least 4-months contrary to a lump associated with a malignant process.

Histology consisting of variable mixture of adipose tissue interspersed with lamellar bone, woven bone, cancellous bone, compact bone and osteoblasts is key to confirm the diagnosis of osteolipoma.

Osteolipoma should not be confused with other benign tumours with bony element including parosteal lipomas and intraosseous lipomas.

Recognising osteolipoma early is important for patient reassurance as well as avoiding unnecessary radical treatment.