Parosteal lipoma of the mandible: a case report of an asymptomatic, non-ossifying variant.

Parosteal lipoma is a rare benign neoplasm arising in intimate association with the periosteum. Involvement of the mandible is exceptionally rare. We present the case of a 75-year-old man presenting with a 1-year history of a painless, fixed mass on the left chin. Unlike previous reports of mandibular parosteal lipomas which often feature ossification or neurologic symptoms, this patient was asymptomatic, and imaging revealed a non-ossifying, homogeneous fat-density mass. The tumor was completely excised via an extraoral approach. Surgically, the mass was firmly adherent to the periosteum, requiring meticulous dissection at the subperiosteal level to ensure complete removal. Histopathology confirmed a simple lipoma. This case highlights a critical diagnostic and surgical lesson for plastic surgeons: a fixed mandibular mass, even if asymptomatic and radiologically benign, suggests potential periosteal adherence. Therefore, surgical planning must prioritize deep, periosteal-level dissection rather than simple enucleation to prevent recurrence.