Intraosseous lipomas are rare, benign bone tumors,comprising less than 0. 1% of all primary bone tumors.Common sites of intraosseous lipomas include the os calcis and the metaphyses of the long bones of the lower limbs.2 Cases involving the spine are extremely rare; a meta-analysis of 206 cases reported that intraosseous lipomas involving the spine (including the sacrum)accounted for 6% of all cases.2 A review of the English literature reveals only 14 reported cases involving the spine (Table). The case involving the upper cervical spine (C 1 and C2) is presented, followed by a discussion of the diagnosis and treatment strategies.