Case Report

Lipoma in tongue – a rare site for a Common tumour

Sasikumar Pattabi, P Sureshbabu, Ramesh Sundarrajan, Satish Reddy

Department of General Surgery, Sree Balaji Medical College And Hospital, Chrompet, Chennai-600044

Submitted June 12, 2013

Accepted July 31, 2013

Published: August 01, 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Although lipomas are among the most common mesenchymal neoplasms, only 1-4% affects the oral cavity. Lipoma of the tongue represents about 0.3% of all benign lesions of the oral cavity [1, 2]. These soft tissue tumors of adipose tissue origin may not derive our attention as such but the site of its presence paves way for driving our attention. Lipoma of tongue is a rare site for a common tumor. Herewith, such a case is presented for its rarity of site.

Key words:

Lipoma, tongue, benign tumour

Introduction

Lipoma is a quite common benign tumour of adipose tissue but its presence in the oral and oropharyngeal region is relatively uncommon on comparative basis of lipomas that present in head and neck. Roux in 1848 identified the first oral lesion and termed it as “yellow epuli” [3, 4].

It is surprising to know that tongue which is devoid of fat cells is also a site for Lipoma rarely and one such case is presented for its rarity.

Case Report

A 48-years old male patient reported to clinic with chief complaint of painless swelling in the lateral border of tongue on left side which was present since two months. The swelling neither interfered with speech nor mastication. No history of trauma / tongue bites / tooth extraction. The patients past history, medical history and systemic review were insignificant. On clinical examination, swelling was soft, measuring approx. 1.5 x 1.5 cm in diameter, present in lateral border of tongue on left side (Figure 1). The mass was inconsistent with well defined border, free from muscles of tongue with slip sign positive, non compressible, non pulsatile. Clinically, swelling corresponds to Lipoma.

 

An excisional biopsy was performed (Figure 2) and the tissue sent for histopathological confirmation. This confirmed our clinical diagnosis of lipoma.

Figure 2: Lipoma being excised from the tongue

Discussion

Lipoma is benign, slow growing tumors of adipose tissue origin with majority located in head and neck. Lipoma of tongue comprises only 4- 5% of all benign tumors in this location [1]. Although most lesion are considered as developmental anomalies, those that occur in the maxillofacial region usually arise after fourth decade and are presumed to be neoplasm of adipocytes and occasionally may be associated with trauma. Solitary lipomas can occur both in subcutaneous or can be situated within connective tissue. Lipomas can be multiple with autosomal dominant inheritance as in neurofibromatosis, gardner syndrome, proteus syndrome and multiple familial lipomatosis Their clinical course is usually asymptomatic until they grow into large sizes [5]. Large tumour has shown to cause dentofacial deformity, anterior open bite and masticatory difficulties as well as airway and speech problems. Clinically they are observed as long standing soft nodular asymptomatic swelling covered by normal mucosa and can be sessile or pedunculated and cases of superficial one, yellow surface discoloration can be noted. On palpation the lesion is situated deep within connective tissue may feel fluid filled, leading to a mistaken diagnosis of cyst [6]. Lipoma if well encapsulated move beneath the mucosa but undemarcated lesion are not movable. The differential diagnosis includes papilloma, fibroepithelial polyp, haemangioma, lymphangioma, neurofibroma, and neuroma [7, 8]. The histopathogy remains the gold standard in the diagnosis of Lipoma. The lipomas mimic surrounding fat with composition of fat cells. But the cell size and shape vary and are usually larger. Lipomas if thinly encapsulated and show distinct lobular pattern but deep seated lipomas are irregular depending on the site of origin. Surgical excision is the main stay of treatment. Recurrence is usually uncommon and can occur especially in case of infiltrating lipomas that tend to invade surrounding muscles.

Conclusions

Lipoma of tongue – a rare site for a common tumour and here is a report of such a case. This universal tumour has stirred our interest in regard with its anatomical location and was treated successfully with excision of the tumour.

Authors Contributions

SP: Literature search, concept and design, preparation of the manuscript

PS: Preparation of the manuscript

RS: Preparation of manuscript.

SR: Concept and design, manuscript prepation.

Conflict of Interest

The authors declare that there are no conflicts of interests.

Ethical Consideration

Written informed consent was obtained from the patient for publication of this case report.

Acknowledgements

None

References

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