Contemporary Clinical Dentistry
   
  Home | About us | Editorial board | Search
Ahead of print | Current Issue | Archives | Advertise
Instructions | Online submission| Contact us | Subscribe |

 

Login  | Users Online: 105  Print this pageEmail this pageSmall font sizeDefault font sizeIncrease font size 



 
 Table of Contents  
CASE REPORT
Year : 2012  |  Volume : 3  |  Issue : 4  |  Page : 507-509  

Huge lipoma of tongue


Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Nagpur, Maharashtra, India

Date of Web Publication20-Feb-2013

Correspondence Address:
Sanjog Chandak
Department No. 106, Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, GMC Campus, Medical Square, Nagpur 440 003, Maharashtra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0976-237X.107457

Rights and Permissions
   Abstract 

Lipoma is the commonest benign tumor 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 cell is also a site for lipoma but very rarely. We report one such rare case of the universal tumor, of 20 years of duration and 9 cm in size, presenting at the lateral margin, dorsal and ventral surface of the tongue, for which complete tumor excision was done.

Keywords: Lipoma, tongue, duration of tumor


How to cite this article:
Chandak S, Pandilwar P K, Chandak T, Mundhada R. Huge lipoma of tongue . Contemp Clin Dent 2012;3:507-9

How to cite this URL:
Chandak S, Pandilwar P K, Chandak T, Mundhada R. Huge lipoma of tongue . Contemp Clin Dent [serial online] 2012 [cited 2019 Jun 26];3:507-9. Available from: http://www.contempclindent.org/text.asp?2012/3/4/507/107457


   Introduction Top


The benign fatty tumor, the lipoma, is composed of adult fat cells that are subdivided into lobules by septae of fibrous connective tissue. It appears most frequently in the subcutis of adults and is histologically indistinguishable from normal adipose tissue. The metabolism of the lipoma differs from that of the normal adipose tissue. It has been shown that the fat of lipoma is not used for energy production during starvation periods as happens with normal adipose tissue. Although lipomas are common in many parts of the body, they are infrequently found in the oral cavity.


   Case Report Top


A 75-year-old man was referred to our department with a tumor tongue, which he had first noticed approximately 16 years earlier. His medical history was non-contributory. The mass measured 9 × 8 cm and was extending from dorsal to ventral surface supero-inferiorly and right to left lateral border of anterior third of tongue [Figure 1] and [Figure 2]. The mass was painless, firm, yellowish in color with multiple engorged blood vessels over its surface. Patient had difficulty in mastication, swallowing. He frequently used to get up from sleep because of obstruction in airway. The lesion was excised under general anesthesia. The tumor was well encapsulated [Figure 3]. The mucosal layers were closed together with absorbable sutures obliterating the dead space. He made an uneventful recovery from the surgery [Figure 4].
Figure 1: Front view of patient

Click here to view
Figure 2: Profile view of patient showing tumor from the tip and ventral surface of the tongue

Click here to view
Figure 3: Surgical specimen

Click here to view
Figure 4: Appearance of tongue 6 months postoperatively

Click here to view


Macroscopic examination showed a single mass of tissue covered with adipose tissue, 9 × 8 × 6 cm and weighting 56 g. The cut surface showed fatty tissue. Microscopically the sections showed sheets of mature adipocytes and extravasated red blood cells. The tumor cells were arranged in lobules. The features were consistent with a lipoma. The patient has since regained normal speech and feeding capacity with no loss of sensory or motor functions of the tongue. The tongue now fits comfortably in the mouth without obstructing the airway.


   Discussion Top


Lipomas are common tumors in the human body, but are less frequent in the oral cavity, comprising no more than 1-5% of all the neoplasms. [1] They commonly present as slow growing asymptomatic lesions with a characteristic yellowish color and soft, doughy feel, in the buccal mucosa, floor of the mouth and tongue in the fourth and fifth decade generally without gender.

Predilection. [2],[3],[4] Some studies, however, have shown a male preponderance. [4] They may present as solitary or multiple lesions, for instance, as in Gardner's or Bournville's syndrome [5] or as macroglosia. [5],[6],[7],[8],[9] Their clinical course is usually asymptomatic until they grow to large sizes. [5] The majority remain unulcerated. When they are ulcerated, they present diagnostic problems. This was noted by a report of a lipoma that presented as a non-healing ulcer. In the present case, the large size interfered with speech and mastication, similar to a case reported by Gray and Barker [5] and also difficulty in respiration. The average duration of the lipoma before excision is 3.2 years with a range of 6 weeks to 15 years. [4] The usual range in size is 0.5-8 cm. [4] The present case was 10 cm in diameter.

The differential diagnosis includes ranula, dermoid cyst, thyroglossal duct cyst, ectopic thyroid tissue, pleomorphic adenoma and mucoepidermoid carcinoma, angiolipoma, fibrolipoma and malignant lymphoma. [6],[7],[8],[9] The definitive diagnosis is by microscopic examination, which shows adult fat tissue cells embedded in a stroma of connective tissue and surrounded by a fibrous capsule. [9] Lipoma has a characteristic radiographic appearance. On Computed Tomography (CT) scan it shows a high density from 83 to 143 Hounsfield units with well or poorly defined margins depending on the capsule.

Ultrasonography shows a lesion, which is around or elliptical in shape with intact or mostly intact capsule. Most lipomas are hypoechoic with echogenic lines or spots. [10] Surgical excision is the mainstay of treatment. [4] Recurrence is reduced by wide surgical excision at the same time preserving the surrounding structures. Well encapsulated lipomas, as the present case, easily shell out with no possibility of recurrence or damage to the surrounding structures. It is still advisable to excise them with a little cuff of surrounding normal tissue to prevent recurrence but still conserving surrounding structures. [3] Infiltrating lipomas are difficult to extirpate and when multiple are liable to recurrence due to difficulty in adequate excision. Recurrence rate of as high as 62.5% has been recorded. [2] Simple lipomas regardless of their size are easily extirpated without recurrence. This unusually huge tongue lipoma was surgically excised uneventfully. The present case demonstrates the size lipomas can grow to, if untreated.

 
   References Top

1.1. Capodiferro S, Scully C, Maiorano E, Lo Muzio L, Favia G. Liposarcoma circumscriptum (lipoma-like) of the tongue: Report of a case. Oral Dis 2004;10:398-400.  Back to cited text no. 1
[PUBMED]    
2.2. Dattilo DJ, Ige JT, Nwana EJ. Intraoral lipoma of the tongue and submandibular space: Report of a case. J Oral Maxillofac Surg 1996;54:915-7.  Back to cited text no. 2
[PUBMED]    
3.3. Fregnani ER, Pires FR, Falzoni R, Lopes MA, Vargas PA. Lipomas of the oral cavity: Clinical findings, histological classification and proliferative activity of 46 cases. Int J Oral Maxillofac Surg 2003;32:49-53.  Back to cited text no. 3
[PUBMED]    
4.4. Furlong MA, Fanburg-Smith JC, Childers EL. Lipoma of the oral and maxillofacial region: Site and subclassification of 125 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:441-50.  Back to cited text no. 4
[PUBMED]    
5.5. Favia G, Maiorano E, Orsini G, Piattelli A. Myxoid liposarcoma of the oral cavity with involvement of the periodontal tissues. J Clin Periodontol 2001;28:109-12.  Back to cited text no. 5
    
6.6. Gray AR, Barker GR. Sublingual lipoma: Report of an unusually large lesion. J Oral Maxillofac Surg 1991;49:747-50.  Back to cited text no. 6
[PUBMED]    
7.7. Moore PL, Goede A, Phillips DE, Carr R. Atypical lipoma of the tongue. J Laryngol Otol 2001;115:859-61.  Back to cited text no. 7
[PUBMED]    
8.8. Nunes FD, Loducca SV, de Oliveira EM, de Araujo VC. Well-differentiated liposarcoma of the tongue. Oral Oncol 2002;38:117-9.  Back to cited text no. 8
    
9.9. Piattelli A, Rubini C, Fioroni M, Iezzi G. Spindle-cell lipoma of the cheek: A case report. Oral Oncol 2000;36:495-6.  Back to cited text no. 9
    
10.10. Zhong LP, Zhao SF, Chen GF, Ping FY. Ultrasonographic appearance of lipoma in the oral and maxillofacial region. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:738-40.  Back to cited text no. 10
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]


This article has been cited by
1 Tongue lipoma in an older male: A case report and literature review of patients with tongue lipoma reported in China
SHU-LAI LU,JIAN-JIN ZHENG,HONG WU,TAO LI,GANG DONG,YUN-LONG WANG,PI-SHAN YANG
Oncology Letters. 2016; 11(1): 419
[Pubmed] | [DOI]
2 Rare fibrolipoma of the tongue: a case report
Giorgio Iaconetta,Marco Friscia,Atirge Cecere,Antonio Romano,Giovanni Dell’Aversana Orabona,Luigi Califano
Journal of Medical Case Reports. 2015; 9(1)
[Pubmed] | [DOI]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Add to My List *
* Registration required (free)  

 
  In this article
    Abstract
   Introduction
   Case Report
   Discussion
    References
    Article Figures

 Article Access Statistics
    Viewed2096    
    Printed42    
    Emailed0    
    PDF Downloaded143    
    Comments [Add]    
    Cited by others 2    

Recommend this journal