Abstract
BACKGROUND: Intraosseous lipomas are extremely rare benign tumors composed of mature adipocytes, accounting for only 0.1% of all bone tumors. These lesions are particularly uncommon in the maxillofacial region, with only seven cases of intraosseous lipoma in the maxilla reported to date. This report presents the first documented case of an intraosseous lipoma located in the maxillary sinus of an Asian patient. CASE PRESENTATION: A 41-year-old female with a history of thalassemia minor presented with discomfort in the right maxillary sinus area. A computed tomography scan revealed a well-demarcated unilocular radiolucency within the right maxillary antrum, associated with an endodontically treated maxillary first molar. Surgical excision was performed under general anesthesia via the Caldwell-Luc approach. The antral wall was reconstructed using titanium mesh and a collagen membrane. The excised specimen was submitted for histopathological evaluation. Histological examination confirmed a diagnosis of intraosseous lipoma, characterized by mature adipocytes in lobules surrounded by woven and cortical bone. No cellular atypia was observed, and surgical margins were clear. Postoperative healing was uneventful. CONCLUSION: This case highlights the diagnostic and therapeutic challenges associated with rare maxillary intraosseous lipomas. The wide variability in clinical and radiological presentation makes diagnosis difficult without histopathological confirmation. As the first reported case of a maxillary sinus intraosseous lipoma in an Asian patient, it expands the documented spectrum of this rare entity. Further case documentation and studies are required to better understand the etiology, presentation, and management of this condition.