Infiltrating lipoma of the mental region: report of a case

Fibrolipoma of the Buccal Mucosa in a Geriatric Patient

Lipoma is the most common mesenchymal tumor seen in the trunk and extremities. It is rarely found in the mouth. Clinically, it resembles other lesions and is not considered in the initial diagnosis. Histopathological evaluation is needed for accurate diagnosis. Surgical excision is the main treatment modality. Histologically, many variants are described of which fibrolipoma is thought to have some recurrence. This article describes a case of fibrolipoma of the buccal mucosa in a geriatric patient.

Lipoma of the nasal septum: A case report

Even routine diagnoses, such as septal deviation, which most people do not think need imaging, require careful examination because rare diagnoses such as lipoma may occur in the nose. Careful examination and imaging lead to the best treatment.

Nasal septal lipoma in a child: Pai syndrome or not?

Lipoma is the most common soft tissue mass in adults but it is uncommon in children. Nasal septal lipoma is an even more rare entity. In this report, a 12-year-old girl was presented with congenital nasal septal lipoma. She had permanent partial nasal obstruction on her right side and disfigurement of her right upper lip. CT scan revealed a lipoma-like mass in the septum plus an additional incidental finding of an intracranial lipoma. Further workup with MRI demonstrated corpus callosum agenesis with interhemispheric lipoma. To remove the mass, septoplasty, nasal lipoma excision and nasal vestibule V-Y advancement flap were performed. To close the lip a rotational advancement flap was required. Our case seemed to be a variety of Pai syndrome. We recommend imaging of the central nervous system in newborns with congenital lipomas located in the craniofacial midline to rule out the Pai syndrome.

Intraoral lipoma: a case report

Lipomas are rare in oral and maxillofacial regions although they are the most common tumours of mesenchymal origin in human body. The etiology remains unclear. Various different theories explain the pathogenesis of this adipose tissue tumour and also different histological variants of oral lipoma have been given in literature. A case of intraoral lipoma occurring in mental region in a 77-year-old male is reported along with review of the literature. Wide surgical excision was performed and two-year followup showed excellent healing without any recurrence. Lipomas are benign soft tissue neoplasm of mature adipose tissue seen as a common entity in the head and neck region. Intraoral lipomas are a rare entity which may be noticed only during routine dental examinations. Most of them rarely cause pain, resulting in delay to seek treatment. It is mandatory for a clinician to diagnose intraoral lipomas using latest diagnostic methods and conservatively treat them without causing much discomfort.

Lipoma of the floor of the mouth: report of an unusually large lesion

Lipomas are among the most common benign tumors affecting the human body. However, they are relatively uncommon in the oral cavity. Oral lipomas are likely to affect cheek, tongue, lips, gingiva and rarely the floor of the mouth. We report a case of huge lipoma of the floor of the mouth, associated with difficulty in speech and mastication in a 72-year-old male. The tumor was completely excised and sent for histopathological examination, which confirmed the tumor to be a simple classical lipoma.

Oral lipoma: analysis of 58 new cases and review of the literature

Lipomas are common soft-tissue tumors but occur infrequently in the oral region. Here, we present 58 new cases of oral lipoma (OL), their clinical features, diagnostic workup, and management. The records of 58 patients with OL were reviewed. Demographic data, presenting symptoms, primary tumor site, histopathology, and clinical management were analyzed. Extraoral and intraosseous lesions were excluded. The patients were 29 men and 29 women with mean age of 59.7 years, range, 11 to 98 years. Tumor sites included the buccal mucosa (n = 31), tongue (n = 10), lip (n = 6), floor of the mouth (n = 6), and vestibule (n = 5). The mean tumor size was 2.1 cm (range, 0.3-5.0 cm). The mean tumor duration before excision was 2.6 years (31.2 months), ranging from 2 months to 12 years. Most common presenting symptom was an asymptomatic, circumscribed mass. Histologically, the tumors were classified as classic lipoma (n = 28), fibrolipoma (n = 19), intramuscular lipoma (n = 4), minor salivary gland lipoma (n = 2), angiolipoma (n = 2), and spindle cell lipoma (n = 3). A case of spindle cell lipoma affecting the lower lip that has not been described previously is presented. The provided treatment was surgical excision. Although uncommon, OL are most common in adults and very uncommon in children. No sex predilection was found. The buccal mucosa region is the most common site followed by the tongue. Classic lipomas are most common in the oral region and comprise 48% of the tumors. A case of spindle cell lipoma of the lower lip is reported. Its clinical, histologic, and cytogenetic workup is the first well-documented case. Further cytogenetic studies should be undertaken to learn more about the pathogenesis and tumorigenesis of OL.

Lipomas of oral cavity: case reports with review of literature

Lipomas represent about 1 to 5% of all neoplasms of the oral cavity. Although relatively common, few large series of intraoral lipomas and its variants are seen in the literature. Therefore, the author presents the four cases of intra-oral lipoma with one case of histological variant of lipoma, the fibrolipoma. All lesions were removed surgically with the intra-oral approach and none showed recurrence.

Lipoma of the parotid gland

We describe three cases of parotid gland lipoma, a relatively rare, asymptomatic, slow growing, freely movable, soft tissue mass. Preoperative clinical diagnosis is generally difficult but MRI using fat saturation techniques provides accurate diagnostic information regarding this benign parotid gland tumor, enabling better treatment planning.

Soft tissue lipoma with the radiographic appearance of a neoplasm within the mandibular canal

Lipomas and lipoma variants are common soft tissue tumours but are not commonly found in the oral and maxillofacial region. We report a case of a classic lipoma located on the medial aspect of the mandibular ramus, but not within bone, first seen by an oral and maxillofacial surgeon during treatment planning for routine extractions. Initial panoramic radiography indicated an expansive tumour in the area of the mandibular foramen and proximal end of the mandibular canal, apparently within the body of the mandible. Subsequent imaging with CT revealed a well-circumscribed soft tissue tumour on the medial aspect of the left mandibular ramus, not within the bone itself. Histological analysis of the operative specimen indicated a classic lipoma.

Lipoma of the oral and maxillofacial region: Site and subclassification of 125 cases

OBJECTIVE

Lipomas and lipoma variants are common soft tissue tumors, but occur infrequently in the oral and maxillofacial region. In this study, we reviewed 125 lipomas in specific oral and maxillofacial locations. We wanted to examine and compare the clinicopathologic features of these tumors. Study design The records from the Oral and Maxillofacial Pathology Registry of the Armed Forces Institute of Pathology from 1970 to the present were searched for cases coded as "lipoma." This study included 125 cases based on location within the oral and maxillofacial region, benign histology, and available clinical information. Subcutaneous and intraosseous lipomas were excluded. The tumors were classified according to the most recent World Heath Organization classification for soft tissue tumors.

RESULTS

Of 125 lipomas, 91 tumors occurred in males, 33 in female patients, and 1 of unknown gender. The mean age was 51.9 years, range 9-92 years. Four tumors occurred in pediatric patients (age <18 years). Specific anatomic sites within the oral and maxillofacial region included the parotid region (n=30); buccal mucosa (n=29); lip (n=21); submandibular region (n=17); tongue (n=15); palate (n=6); floor of mouth (n=5); and vestibule (n=2). The mean size of tumors was 2.2 centimeters, range 0.5 to 8.0 centimeters. The mean duration of the tumors prior to excision was 3.2 years, range 6 weeks to 15 years. Most patients presented with an asymptomatic, circumscribed mass. Grossly, most tumors were described as pink and smooth, occasionally mucoid. Histologically, the tumors were subclassified as classic lipomas (n=62); spindle cell/pleomorphic lipomas (n=59); fibrolipoma (n=2), and chondroid lipoma (n=2). Fourteen tumors exhibited secondary changes, such as fat necrosis, atrophy, and prominent hyalinization; 23 tumors were histologically confirmed to be intramuscular.

CONCLUSIONS

Lipomas of the oral and maxillofacial region occur most commonly in adult males in the parotid region, followed closely by the buccal mucosa. These tumors are uncommon in children. Interestingly, spindle cell lipomas are common in this region and comprise the majority of our parotid and lip tumors. Angiolipomas were absent in this anatomic region in this study. Secondary changes and atrophy should not be confused with the malignant histologic features of a liposarcoma.

Intramuscular lipoma within the temporal muscle

A 61-year-old male presented with a 6-month history of a subcutaneous nodule on the left forehead, which had gradually enlarged. He had suffered from headaches from 20 days before the first visit. His medical history included hepatitis C virus infection. He had had no history of trauma in this area. Clinical examination showed a subcutaneous soft nodule, 15 x 15 mm in size, which was adjacent to the left superficial temporal artery (Fig. 1). Though this artery revealed strong pulsation, the nodule had neither pulsation nor tenderness. His headache was localized in the left temporal area. He had no complaints of fever or weakness. Clinically, these features suggested a pseudoaneurysm of the superficial temporal artery. We operated on him under local anesthesia. An incision through the skin and subcutaneous fat exposed a nodule located within the temporal muscle. The fine branches of the superficial temporal artery reached out to the nodule through the muscle. After ligation of the branches, we resected the nodule surrounded by muscular tissue. Histopathology showed the proliferation of mature adipose cells embedded in muscular fibers. These cells had no nuclear pleomorphism or mitoses (Fig. 2). The tumor tissue contained partial fibrosis and some muscular fiber bundles scattered between the adipose cells (Fig. 3). Intramuscular lipoma within the temporal muscle was diagnosed. His headache was reduced after the operation, and he has had no recurrence of the tumor for 16 months. The relationship between the tumor and his headache was unknown.

Spindle cell lipoma of the alveolar mucosa: a case report

Spindle cell lipoma of the oral cavity is extremely rare. We report a case occurring on the alveolar mucosa, an oral site that has not been previously reported. A short review of the literature is also presented. The importance of distinguishing this benign lesion from a sarcoma is highlighted. The lesion was excised, and no recurrence has been reported after 2 years.

Benign tumors of adipose tissue of the oral cavity: a clinicopathologic study of 13 cases

PURPOSE

The purpose of this study was to determine the clinical and histologic features of 9 simple lipomas, 2 fibrolipomas, and 2 infiltrating lipomas of the oral cavity. In addition, 10 cases of infiltrating lipoma of the oral cavity previously reported in the literature were reviewed.

MATERIALS AND METHODS

All cases were retrieved from the archives of the Department of Oral Medicine/Pathology of the University of Thessaloniki, Greece. Data on age, sex, location, clinical appearance, duration, recurrence, and histologic appearance were evaluated.

RESULTS

This study showed that the sex distribution of the simple lipomas was approximately equal, and the mean age of patients was 60.2 years. The buccal mucosa was the most frequent location of the tumors. Their size ranged from 0.2 to 1.5 cm, with an average rate 0.8 cm. In 3 cases, the tumor was not encapsulated. The sex distribution of the infiltrating lipomas was equal, and the mean age of the patients was 36.8 years. The most frequent location was the tongue.

CONCLUSIONS

Tumors of adipose tissue represent rare neoplasms of the oral cavity. The diagnosis is based on both the clinical and histologic characteristics. Caution is required during their surgical excision to avoid recurrence, especially with infiltrating lipomas.

Infiltrating lipoma of the head and neck: a report of one pediatric case

Infiltrating lipomas are rare benign tumors. Several cases have previously been reported in the oral cavity but only three cases have been reported to date in children. We report a case of a 7-year-old child with an infiltrating lipoma of the neck and a posterior extension to the fourth and fifth cervical roots and the vertebral artery. The absence of any neurological signs, negative clinical and radiological examination results, as well as, the surgical risk of total removal and high rate of recurrence suggested a period of watchful waiting. After 5 years, the patient's clinical and radiological characteristics remain stable. A review of the literature regarding this pathology in the head and neck area, in both children and adults is also presented.

Imaging findings of lipomas in the orofacial region with CT, US, and MRI

OBJECTIVE

The aim of this study was to document retrospectively the imaging findings of lipomas with the use of computed tomography, ultrasonography, and magnetic resonance imaging.

STUDY DESIGN

Thirteen patients with 11 lipomas and 2 lipomatoses were evaluated. Eleven cases were examined by computed tomography, 9 by ultrasonography, and 3 by magnetic resonance imaging.

RESULTS

Lipomas had a density ranging from -134 to -83 Hounsfield units, (mean-108) on the computed tomography images. The margins were ill defined in 9 of 10 cases. The superficial muscles were displaced externally in 8 cases and internally in 2 cases. With ultrasonography, 8 lesions were hypoechoic, and one was hyperechoic. All three lesions had a high signal intensity on both T1- and T2-weighted images.

CONCLUSIONS

Lipomas had a specific range of computed tomography Hounsfield unit values and also displaced the surrounding soft tissue. Although some variation in the ultrasonographic appearance was observed, the lesions tended to be hypoechoic. These findings may be useful for diagnosing lipomas in the orofacial region.

Oral infiltrating lipomas

Infiltrating lipomas are unusual benign tumours of mesodermal origin which infiltrate adjacent skeletal muscle and tend to recur after excision. We report three previously unrecorded cases that developed about the mouth, and describe the clinical characteristics of these lesions, together with those of the seven previously reported cases. We have identified a number of differences from oral lipomas that could be of diagnostic value.