A Case Report on the Diagnostic Challenge of Mandibular Osteolipoma

Osteolipoma is an extremely rare histological variant of lipoma characterized by the presence of mature adipose tissue admixed with well-formed lamellar bone. Its occurrence in the oral cavity is exceptional, often posing a diagnostic challenge due to its nonspecific clinical and radiographic features. We report a rare case of osteolipoma in a 40-year-old male who presented with a slow-growing, painless swelling on the right side of the mandible of six months' duration. Clinical examination revealed a firm, mobile, non-tender mass causing facial asymmetry and intraoral vestibular obliteration. Radiographic evaluation, including mandibular lateral topographic radiograph and cone beam computed tomography, demonstrated a well-defined mixed-density lesion with internal calcifications, initially suggestive of a peripheral ossifying fibroma. Complete surgical excision was performed. Histopathological examination revealed an encapsulated lesion composed of lobules of mature adipocytes interspersed with trabeculae of mature bone, confirming the diagnosis of osteolipoma. The patient was recalled one week postoperatively and placed on periodic clinical and radiographic follow-up at three months interval, and no recurrence was noted. Osteolipoma of the oral cavity is a rare benign neoplasm with excellent prognosis following complete surgical excision. Due to its rarity and resemblance to other calcified soft-tissue lesions, histopathological examination remains essential for definitive diagnosis. Reporting such cases contributes to a better understanding of the clinicopathological spectrum and biological behavior of this uncommon entity.