Infiltrating lipoma of the tongue

Treatment of intramuscular lipoma of tongue with enveloped mucosal flap design: a case report and review of the literature

Background

Lipomas are benign soft tissue neoplasms of mature adipose tissue commonly occurring in the trunk or extremities. But, intraoral lipomas are rare entities which may be only noticed during routine dental examinations. Especially intramuscular lipomas on the tongue have been reported very rarely. In this study, we report a case of intramuscular lipoma on tongue, with a review of the literature from 1978 to 2019, providing data on age, gender, location, presenting symptoms, size, surgical methods, and recurrence.

Case presentation

A case of intramuscular lipoma occurring in tongue region in a 65-year-old male is reported. Surgical excision is the mainstay of treatment for the lesion. In order to decrease the deformity and discomfort after the excision, we tried to modify surgical technique using enveloped mucosal flap. This technique provided more comfortable healing procedure on the operative site without recurrence.

Conclusion

This is a rare case of large intramuscular lipoma on tongue. Surgical excision with enveloped mucosal flap design was performed to diminish postoperative raw surface and discomfort and a 24-month follow-up showed excellent healing without any recurrence. A case of intramuscular lipoma on tongue and relevant literature reviews are presented in this study.

Lipoma of tongue - A rare site for a rare site for a common tumour

Lipoma is the commonest benign tumour occurring at any anatomical site where fat is present. In oral cavity and oropharynx it is a relatively uncommon neoplasm.. Tongue which is totally devoid of fat cells is also a site for lipoma albeit very rarely. This is one such rare case of the universal tumour, presenting at the lateral margin of the tongue, for which complete tumour excision was done.

Dumbbell-formed lipomas under the zygomatic arch

Two cases of dumbbell-shaped lipoma under the zygomatic arch and the therapeutic courses are described. Both tumours were present in the buccal and temporal processes and the isthmus, which showed dumbbell forms occupying temporal and infratemporal fossae on coronal MR images. According to the location, the tumours seemed to be derived from a masticatory fat pad. The tumours were completely excised via a temporal and small cheek skin incision, with no postoperative complications. Over the 5-year follow-up period, both cases have shown good function and aesthetics, and no recurrences have been observed.

Well-circumscribed intramuscular lipoma of the sternocleidomastoid muscle

Intramuscular lipomas are unusual benign mesenchymal tumours, which infiltrate the skeletal muscle, and are exceedingly rare in the head and neck region. They commonly infiltrate the skeletal muscle fibres from which they arise and are rarely well circumscribed. We present the only documented case of well-circumscribed intramuscular lipoma arising from the sternocleidomastoid muscle. Although the recurrence is commoner in the infiltrative variety the surgeon should be aware that differentiation between infiltrative and well circumscribed is based on histological diagnosis, and hence wide excision in all cases of intramuscular lipomas is essential.

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.

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.

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.

Infiltrating lipoma of the mental region: report of a case

Lipoma is an uncommon tumour in the oral cavity. Infiltrating lipoma is extremely rare. An infiltrating lipoma of the mental region in a 48-year old woman is reported. Wide myectomy was performed, and follow-up showed excellent healing without recurrence.