Clinicoradiographic Features and Histopathologic Variations
Intraosseous lipoma (IOL) is the rarest benign primary bone neoplasm and accounts for about 0.1% of all bone tumors. Its commonest location is the metaphysis of the long bones and the calcaneus. It is often discovered incidentally during radiographic examinations, although it may be associated with pathological fractures. IOLs are almost always solitary but multiple lesions have also been reported. IOLs of long bones show discrete osteolytic lesions, often with sclerotic border and radioopacities in the center due to fatty necrosis and calcification.

A 39-year-old man with a chief complaint of tooth displacement in the mandibular left lateral incisor and the canine area was referred to a private dental clinic. There was neither a history of medical problems nor trauma. The extraoral examination was within normal limits and the intraoral examination revealed no expansion or inflammation. The displaced teeth were vital. Cone-beam computed tomography (CBCT) revealed an approximately 2?cm, unilocular radiolucent lesion with sclerotic borders located between the mandibular left lateral incisor and canine which causes root divergence of the involved teeth. There was no evidence of root resorption.

Lateral periodontal cyst, odontogenic keratocyst, and central giant cell granuloma were considered as differential diagnoses. To make a final diagnosis, an excisional biopsy was performed under local anesthesia in the same month. The gross of the specimen showed a well-defined, solid, yellow lesion with a soft consistency. Microscopic examination showed a well-defined mass composed of mature fat cells intermixed with fibrous connective tissue. The histopathological features in combination with radiologic findings were consistent with the diagnosis of intraosseous fibro lipoma. The patient has been under follow-up and free of disease until now.