Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Orthognathic surgery with removal of lipoma in the asymmetric mandibular prognathism of a patient with a mandibular bone defect due to intramuscular lipoma on the medial aspect of the ramus: a case report

  • Yoon Ju Nam (Department of Oral and Maxillofacial Surgery, Dong-A University College of Medicine) ;
  • Min Seong Kang (Department of Oral and Maxillofacial Surgery, Dong-A University College of Medicine) ;
  • Jung Han Lee (Department of Oral and Maxillofacial Surgery, Dong-A University College of Medicine) ;
  • Bok Joo Kim (Department of Oral and Maxillofacial Surgery, Dong-A University College of Medicine) ;
  • Jung Han Kim (Department of Oral and Maxillofacial Surgery, Dong-A University College of Medicine) ;
  • Chul Hoon Kim (Department of Oral and Maxillofacial Surgery, Dong-A University College of Medicine)
  • Received : 2024.05.11
  • Accepted : 2024.06.14
  • Published : 2024.08.31
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Abstract

Lipomas, the most common soft-tissue mesenchymal neoplasms in adults, are characterized by the proliferation of mature white adipocytes without cytologic atypia. Lipomas are rarely observed in the head and neck region. We present a case of resection and orthognathic surgical removal of an intramuscular lipoma of the mandible with involvement of the mandibular ramus and condylar head and neck. An 18-year-old female patient was referred to our hospital for orthognathic surgery for the management of facial asymmetry and mandibular prognathism. The patient did not present with facial swelling, pain, or temporomandibular dysfunction; however, on radiographic examination, including cone-beam computed tomography and magnetic resonance imaging, an infiltrative fatty lesion was observed in the masticator space inside the right mandible, and the adjacent mandible exhibited bone thinning and deformity. Resection of the lipoma was performed along with orthognathic surgery, including a Le Fort I osteotomy for the maxilla and bilateral sagittal split ramus osteotomy (BSSRO). In this case, because the ramus was split using BSSRO, accessing the lipoma intraorally was easy. Consequently, aesthetic scarring was avoided, and no complications, such as unfavorable splitting or pathologic fracture, occurred. Although recurrence has not been observed about 1 year, long-term follow-up should be performed.

Keywords

Acknowledgement

This work was supported by the Dong-A University research fund.

References

  1. Iwai T, Sugiyama S, Hirota M, Mitsudo K. Endoscopically assisted intraoral resection of lipoma in the masticator space. Ear Nose Throat J 2022;101:33-5. https://doi.org/10.1177/0145561320940058 
  2. Barca I, Lo Faro C, Cordaro R, Novembre D, Mignogna C, Cristofaro MG, et al. Intramuscular lipoma involving the masticator space: a case report. J Oral Maxillofac Surg Med Pathol 2019;31:208-11. https://doi.org/10.1016/j.ajoms.2019.02.003 
  3. Mehta J, Mishra M. Intraosseous lipoma of the mandible: a case report and short review of the literature. Oral Surg 2018;11:323-8. https://doi.org/10.1111/ors.12357 
  4. Navaneetham A, Rao A, Gandhi A, Jeevan CA. Lipoma involving the masticator space. Ann Maxillofac Surg 2011;1:93-4. https://doi.org/10.4103/2231-0746.83147 
  5. Gonzalez-Perez LM, Perez-Ceballos JL, Carranza-Carranza A. Mandibular intraosseous lipoma: clinical features of a condylar location. Int J Oral Maxillofac Surg 2010;39:617-20. https://doi.org/10.1016/j.ijom.2010.01.011 
  6. Sanjuan A, Dean A, Garcia B, Alamillos F, Roldan E, Blanco A. Condylar intramedullary intraosseous lipoma: contribution of a new case and review of the literature. J Clin Exp Dent 2017;9:e498-502. https://doi.org/10.4317/jced.53421 
  7. Manor E, Sion-Vardy N, Joshua BZ, Bodner L. Oral lipoma: analysis of 58 new cases and review of the literature. Ann Diagn Pathol 2011;15:257-61. https://doi.org/10.1016/j.anndiagpath.2011.01.003 
  8. Fregnani ER, Pires FR, Falzoni R, Lopes MA, Vargas PA. Lipomas of the oral cavity: clinical findings, histological classification and proliferative activity of 46 cases. Int J Oral Maxillofac Surg 2003;32:49-53. https://doi.org/10.1054/ijom.2002.0317 
  9. Furlong MA, Fanburg-Smith JC, Childers EL. Lipoma of the oral and maxillofacial region: site and subclassification of 125 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:441-50. https://doi.org/10.1016/j.tripleo.2004.02.071 
  10. Tettamanti L, Azzi L, Croveri F, Cimetti L, Farronato D, Bombeccari GP, et al. Oral lipoma: Many features of a rare oral benign neoplasm. Head Neck Oncol 2015;6:1-7. 
  11. Matsumoto K, Hukuda S, Ishizawa M, Chano T, Okabe H. MRI findings in intramuscular lipomas. Skeletal Radiol 1999;28:145-52. https://doi.org/10.1007/s002560050491 
  12. Dooms GC, Hricak H, Sollitto RA, Higgins CB. Lipomatous tumors and tumors with fatty component: MR imaging potential and comparison of MR and CT results. Radiology 1985;157:479-83. https://doi.org/10.1148/radiology.157.2.4048459 
  13. Han X, Shao X, Lin X. Intraosseous lipoma in the mandibular condyle. J Craniofac Surg 2020;31:e766-78. https://doi.org/10.1097/SCS.0000000000006747