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

Department of Pathology, Georgetown University, Washington, DC, USA.
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology (Impact Factor: 1.46). 10/2004; 98(4):441-50. DOI: 10.1016/S1079210404001805
Source: PubMed


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.
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.
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.

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    • "Oral lipomas are usually well encapsulated and has good prognosis after complete surgical recession.[5] In adults, the recurrence is rare, but a long term follow-up is necessary in patients <18 years.[11] "
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    ABSTRACT: Lipoma is a benign neoplasm of mature fat cells. Although a common mesenchymal neoplasm of trunk and extremities, its occurrence in the oral and oropharyngeal region is rather rare. Lipoma accounts for 1-5% of all benign oral tumors, occurring in patients above 40 years of age with slight male predilection. Oral lipoma presents as asymptomatic, slowly growing mass rarely exceeding 25 mm in diameter. Documented here is a rare case of a large size lipoma (>3 cm in diameter) occurring as an extraoral swelling in a girl aged 13 years, which was subsequently diagnosed and treated 4 years later. Furthermore discussed are the peculiarities in the clinical presentation, differential diagnosis, and investigations for this case.
    04/2014; 5(2):236-9. DOI:10.4103/0976-237X.132363
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    • "One subtype is the spindle cell lipoma (SCL), which typically presents as a benign lipomatous neoplasm in the posterior neck and back of older males, and accounts for approximately 1.5% of all lipoma cases.3 In adult males, the most common location for classic oral and maxillofacial lipomas is the parotid region, followed by the buccal mucosa.4 However, oral SCLs are rare, and only about 40 cases have been reported.5 "
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    ABSTRACT: Spindle cell lipoma (SCL) is a benign lipomatous neoplasm typically located in the posterior neck and back of older males. It presents as a well-circumscribed mass in the buccal mucosa, tongue, floor of the mouth or hard palate. There are only two case reports of SCL in the gingiva and alveolar ridge. Here, we report a case of SCL in the mandibular mucogingival junction of a 68-year-old male. Clinical, histopathological and immunohistochemical findings are presented. Although oral SCL is rare, it should be considered in the differential diagnosis of spindle cell neoplasms occurring in the oral cavity.International Journal of Oral Science (2014) 6, doi:10.1038/ijos.2014.3; published online 21 February 2014.
    International Journal of Oral Science 02/2014; 6(3). DOI:10.1038/ijos.2014.3 · 2.53 Impact Factor
    • "Atrophy of the glandular structures, ductal dilation with scattered foci of fibrosis, sebaceous and squamous metaplasia, oncocytic changes, myxoid islands, lymphocyte infiltration, inside the lipomatous proliferation are also present.[12378] The histopathologic differential diagnosis of sialolipoma includes lipoma and pleomorphic adenoma.[7910] Lipoma usually contains mature encapsulated fatty cells, but sialolipoma has salivary gland elements between adipose tissue. "
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    ABSTRACT: Sialolipoma is a rare neoplasm of salivary glands, described as a distinct entity by Nagao et al. in 2001. Thirty-six cases of sialolipoma in minor and major salivary glands have been reported thus far in addition to the two new cases of sialolipoma arising in the major salivary glands in this study. Thirty-six cases of sialolipoma published in English language reports were analyzed considering gender, age, location, size, duration of symptoms, treatment mode, follow-up, and histologic findings. Congenital sialolipomas were considered in this study. The first case occurred in a 45-year-old female and presented as a localized swelling in right parotid area. The second case occurred in an 18-year-old female as a swelling in the left parotid region. On histopathological examination, these lesions were diagnosed as sialolipoma.
    Dental research journal 04/2013; 10(1):93-7. DOI:10.4103/1735-3327.111807
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