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The age and gender of this patient are typical for those of patients with lipoma of the mouth. The clinical description of soft consistency is also typical of a lipoma, as is the slow growth and the asymptomatic clinical presentation. The histology is consistent with that of a benign lipoma.
Lipomas are benign neoplasms of adipose tissue origin. They are more commonly described in the trunk and extremities and are rare in the oral cavity. Their overall incidence in the oral cavity accounts for around 4.4% of all benign oral lesions. In a recent study from the Armed Forces Institute of Pathology (AFIP) of 125 benign lipomas in and around the mouth, the male to female ratio was approximately 3:1, which is not surprising given the study was conducted within a military population. Other studies reveal an equal gender distribution. The AFIP study showed the mean age to be 52 with a range of 9-92 years. Only 4 of the 125 cases involved patients under 18. In the mouth, the most common location for this neoplasm is the buccal mucosa followed by the lips, submandibular area, tongue, palate and, less often, in the floor of mouth and vestibule. These findings are consistent with many other published reports. These lesions are slow-growing and can be present for many years. Lipomatous nodule of the buccal mucosa may represent herniation of the buccal fat pad. Lipomas usually present as a single, smooth surfaced, soft with doughy consistency, lobulated, painless, yellowish, sessile nodule. The overlying mucosa is usually thin and stretched with visible blood vessels. Because of its softness it can be mistaken for a cyst. Histologically, lipomas are variable benign histologies. Some have predominant lobules of mature adipocytes surrounded by a thin connective tissue capsule, while others have a predominant spindle-cell component, myxoid, chondroid, or connective tissue component. Some are intramuscular. Each has its own clinical behavior. Simple surgical excision is the treatment of choice for the simple, mature adipocyte component.
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