Intraosseous angiolipoma of the mandible: case report of a rare entity

Background

Intraosseous angiolipoma is a benign adipocytic lesion that may occur at any bony site, with predilec- tion for the long bones, ribs, vertebrae, and the head and neck region. As the name suggests, the lesion is character- ized by the presence of mature adipocytes associated with increased vascularity. Intraosseous angiolipoma of the mandible is an exceedingly rare condition first described by Polte in 1976. Until the present date, only four cases were documented in the English literature. Case description: We report a case of a 58 year-old woman presenting with an asymptomatic lesion of the mandible. CBCT examination shows a hypodense area extending from the api- cal region of the mandibular first molar to the mid portion of the mandibular ramus, right side. Lesion is localized, multilocular, with scalloped borders and partially corticated. There is thinning of the facial and lingual cortices, with focal areas of expansion and bone discontinuity. The cortices of the inferior alveolar canal are not visual- ized in some portions. No root resorption is identified. The clinical impression was ameloblastoma. Enucleation and curettage was performed. Microscopic examination reveals the presence of mature adipocytes surrounded by fibrous connective tissue septa featuring numerous vascular channels. Scattered chronic inflammatory cells includ- ing mast cells are seen. No cellular atypia or increased mitotic activity are identified.

Conclusion

We present the fifth case of an intraosseous angiolipoma involving the mandible. The lesion has been classified as either a hyper- plastic process or a benign neoplasm. The differential diagnosis often includes vascular lesions, benign odontogenic entities, central giant cell granuloma, or low-grade intraosseous malignancies. Due to the scarcity of case reports, the nature of the lesion as well as its preferred treatment method are still to be determined.