Tlaiss Y, Abou Zeki L, Farhat H, Warrak J, Yazbeck M, Al-Awar O. Intraosseous lipoma of the sphenoid bone causing optic nerve compression: A case report. World J Clin Cases 2026; 14(2): 116519 [DOI: 10.12998/wjcc.v14.i2.116519]
Corresponding Author of This Article
Yehya Tlaiss, MD, Department of Ophthalmology, University of Balamand, The Backyard Street, Hazmieh, Beirut 1100, Beyrouth, Lebanon. yehyatlaiss@hotmail.com
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Ophthalmology
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Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 16, 2026 (publication date) through Jan 23, 2026
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World Journal of Clinical Cases
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Tlaiss Y, Abou Zeki L, Farhat H, Warrak J, Yazbeck M, Al-Awar O. Intraosseous lipoma of the sphenoid bone causing optic nerve compression: A case report. World J Clin Cases 2026; 14(2): 116519 [DOI: 10.12998/wjcc.v14.i2.116519]
World J Clin Cases. Jan 16, 2026; 14(2): 116519 Published online Jan 16, 2026. doi: 10.12998/wjcc.v14.i2.116519
Intraosseous lipoma of the sphenoid bone causing optic nerve compression: A case report
Yehya Tlaiss, Layal Abou Zeki, Hadi Farhat, John Warrak, Mohamad Yazbeck, Omar Al-Awar
Yehya Tlaiss, John Warrak, Department of Ophthalmology, University of Balamand, Beirut 1100, Beyrouth, Lebanon
Layal Abou Zeki, Omar Al-Awar, Department of Neurosurgery, University of Balamand, Beirut 1100, Beyrouth, Lebanon
Hadi Farhat, Department of General Surgery, University of Balamand, Beirut 1100, Beyrouth, Lebanon
Mohamad Yazbeck, Department of Neurosurgery, Lebanese University, Beirut 1100, Beyrouth, Lebanon
Author contributions: Tlaiss Y conceived the study, collected and interpreted ophthalmologic data, and drafted the manuscript; Abou Zeki L planned and performed the neurosurgical procedure and interpreted intraoperative findings; Abou Zeki L, Farhat H, and Yazbeck M critically revised the manuscript; Farhat H assisted in surgery, contributed to perioperative management; Warrak J contributed to clinical data collection, literature review, and drafting of the discussion; Yazbeck M analyzed and interpreted neuroimaging, prepared imaging figures; Al-Awar O supervised overall clinical management, provided senior neurosurgical input, and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yehya Tlaiss, MD, Department of Ophthalmology, University of Balamand, The Backyard Street, Hazmieh, Beirut 1100, Beyrouth, Lebanon. yehyatlaiss@hotmail.com
Received: November 13, 2025 Revised: December 4, 2025 Accepted: December 22, 2025 Published online: January 16, 2026 Processing time: 64 Days and 5.7 Hours
Abstract
BACKGROUND
Intraosseous lipomas are rare developmental anomalies that present with visual impairment. Due to their infrequency, they often pose diagnostic challenges, particularly in differentiating them from more common optic nerve pathologies. Magnetic resonance imaging (MRI) plays a crucial role in the early identification and management of these lesions.
CASE SUMMARY
We present the case of a 41-year-old male with a history of dyslipidemia who developed sudden onset headaches and decreased vision in his left eye. MRI revealed a T1-hyperintense fat-containing lesion within the left anterior clinoid process of the sphenoid bone at the optic canal, causing extrinsic compression of the left optic nerve, initially interpreted as a lipoma. Intraoperatively, the previously thought lipoma lesion was actually shown to be adipose tumor of the bone and pathological examination confirmed the diagnosis. The left optic nerve was successfully decompressed, and the patient’s vision improved significantly post-op. This case highlights that while MRI is essential in evaluating optic nerve compressive lesions, radiologic findings alone may be insufficient, and surgical and pathological correlation remains crucial for accurate diagnosis.
CONCLUSION
This case highlights the importance of considering intraosseous lipoma of the sphenoid bone as a rare cause of optic nerve compression and emphasizes the pivotal, but not definitive, role of MRI, which must be complemented by surgical and histopathological correlation to prevent irreversible visual loss.
Core Tip: This case report describes a rare intraosseous lipoma of the sphenoid bone causing compressive optic neuropathy and reversible vision loss in a middle-aged patient. Magnetic resonance imaging (MRI) suggested a lipomatous lesion, but definitive diagnosis required intraoperative findings and histopathological confirmation of an adipose tumor of bone. Successful optic nerve decompression led to significant visual recovery. This case underscores the need to consider intraosseous lipoma in the differential diagnosis of optic nerve compression and to correlate MRI with surgical and pathological findings.
