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.

摘要 目的：由于骨脂肪瘤（Osteolipoma）较为罕见，目前学界对其临床表现、诊疗策略、影像学特征、组织学特征及预后的认知均存在不足；加之其鉴别诊断谱较广，常给临床医师与病理学家带来诊疗难题。本研究旨在梳理、分析并呈现相关细节，以扩充头颈部骨脂肪瘤的现有文献储备。方法：本研究于2021年5月1日前，针对头颈部骨脂肪瘤相关文献，在PubMed/MEDLINE、EMBASE、CINAHL、Science Citation Index、Google Scholar及Cochrane数据库中开展全面检索。随后对纳入文献的参考文献列表进行核查与交叉引用，补充其余相关发表文献至本综述中。结果：本研究共纳入文献报道的38例病例。头颈部区域最常见的受累部位为口腔，共计21例（56.8%），其次为颈部，共7例（19.0%）。29例（78.4%）患者以软组织肿胀或肿块为首发表现，为该疾病最常见的临床症状。所有患者均接受手术切除肿瘤：其中18例（48.6%）采用经口入路切除，6例（16.2%）采用开放式经颈入路切除，包含1例经咽侧切开术的病例。共有12篇文献报道了长期随访结果（中位随访时间为12个月），随访期间未出现肿瘤复发；仅1例患者在术后5年出现肿瘤再生长。结论：骨脂肪瘤是一种罕见的软组织肿瘤，鉴别诊断谱广泛，需与多种恶性病变相鉴别。通过熟悉该病的临床表现、影像学特征及组织病理学表现来识别该良性肿瘤，对于安抚患者情绪、避免不必要的根治性治疗具有重要意义。