466Journal of Maxillofacial & Oral Surgery 2008 Vol. 7 : No. 4
, Sonia Goyal
PG studentDepartment of Oral and MaxillofacialSurgery, I.T.S Centre for Dental Studiesand Research
Address for Correspondence:
Department of Oral & MaxillofacialSurgeryI.T.S Centre for Dental Studies &Research, MuradnagarDelhi-Meerut RoadGhaziabad – 201 206, Uttar PradeshPh: 09899450488E-mail: firstname.lastname@example.org
Received for publication August 2008Accepted after peer review December 2008Available online Dec. 2008 at www.jmosi.com
Lipoma in theSubmandibular Region: ACase Report
Suhas Godhi, Sonia Goyal, Manish Pandit
Lipomas in the submandibular region are relatively rare. This casereport presents a case of lipoma in submandibular region in a 35 year old Indianmale. Lipomas and its variants are common soft tissue tumors but are not commonly are in the oral and maxillofacial region. Lipoma of the oral and maxillofacial region occurs most commonly in the parotid region, followed closelyby buccal mucosa. It is composed of adult fat cells that are subdivided into lobuleby septae of fibrous connective tissue. Surgical excision is the treatment of choicewith recurrence not expected.
Lipoma and submandibular.
Case Reports - Cysts & Tumours
Lipoma is a common, slow growing,benign, encapsulated tumor of fatty tissuethat is rare in the oral cavity. It was firstreported in 1887 by Grosch.
Lipomas arethe most common soft tissue mesenchymalneoplasms, with 15 to 20% of the casesinvolving the head and neck region and 1%to 4% affecting the oral cavity.
found only three oral tumorsin a series of 440 lipomas.The lipoma represents 0.1% to 5% of all benign tumors of the mouth. They areusually found as long standing soft nodularasymptomatic swellings covered by normalmucosa. Oral lipomas affect predominantlythe buccal mucosa, floor of mouth, tongueand lips.
Histologically, they can be classifiedas simple lipomas or its variants such asfibrolipomas, Spindle Cell Lipomas(SCL), intramuscular lipomas,angiolipomas, salivary gland lipomas,plemorphic lipomas, myxoid lipomas andatypical lipomas. Angiolipomas andinfiltrating lipomas are rarely found in theoral cavity.
According to Furlong et al lipoma of the oral and maxillofacial region occur mostcommonly in adult male in the parotidregion, followed closely by buccal mucosa.This entity is rare in children.
A 35 year old male patient presentedwith a painless,gradually increasing, welldefined, oval shaped extraoral swellingmeasuring, approximately 6x4 cm in leftsubmandibular region with 13 yearsduration. On palpation, a soft rubbery masscould be felt and slipping sign was present.The transillumination test was negative.Medical history was noncontributory. Theultrasonograph revealed an elliptical massin right submandibular region that washyper-echoic relative to the adjacentmuscle. Based upon the classical sign of slipping edge and ultrasonography thediagnosis of lipoma was made. The patientwas admitted for excision of the mass undergeneral anesthesia. Routine preoperativeinvestigations were within normal limits.A submandibular incision was made,and a yellowish, soft encapsulated mass wasremoved by blunt dissection. The massshelled out easily with no adhesion toadjacent structures. Postoperative recoverywas uneventful. The patient was underfollowup for 22 months and showed norecurrence.Histological investigation showed thelesion to be macroscopically solid andconsisting entirely of microscopicallyencapsulated fatty tissue with areas of fibrosis. The adipocytes are looselyarranged in large areas which showpresence of empty cytoplasm and smallnuclei.
Lipoma presents clinically as a sessileor pedunculated mass which is slowgrowing, freely mobile, and may or maynot have a yellow hue, depending on depthof localization and degree of fibrosis.
De Visscher et al studied the clinicaland histological characteristics of lipomasand fibrolipomas of the oral cavity. Themale-female ratio for lipomas was 1.5:1,and for fibrolipomas 1:1.3. In most casesthe only symptom was a painless, palpabletumour. The cheek was the most favouredsite, followed by the tongue, floor of mouthand buccal sulcus and vestibule equally, lip,palate, gingiva and retromolar area.
The benign fatty tumor, the lipoma, iscomposed of adult fat cells that are