Intraosseous spindle cell lipoma of the maxilla: case report and review of the literature.

Intraosseous lipomas are rare benign tumors of mesenchymal origin, particularly unusual in the maxilla. Spindle cell lipomas, a histological subtype, are even more uncommon, with limited cases reported in the literature. This report documents a rare case of intraosseous spindle cell lipoma in the anterior maxilla of a 66-year-old male and presents a review of 39 gnathic lipoma cases from the literature published between 1976 and 2024. The majority of the gnathic intraosseous lipomas (32/39, 82%) occurred in the mandible. The posterior region was more frequently affected than the anterior region (24/39, 62%), in both maxilla and mandible cases (86% and 56%, respectively). Most lesions presented as a well-defined radiolucency; however, the lesions may appear multilocular and may range from radiolucent to mixed radiolucent-radiopaque to 'ground glass'. Surgical excision or enucleation was the most common treatment. Intraosseous spindle cell lipomas are exceedingly rare. Based on the available evidence, surgical excision is the recommended treatment with a favorable prognosis and low recurrence rate.