Oral lipoma: analysis of 58 new cases and review of the literature Esther Manor, PhD a , Netta Sion-Vardy, MD b , Ben Zion Joshua, MD c , Lipa Bodner, DMD d, ⁎ a Institute of Human Genetics, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84101, Israel b Department of Pathology, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84101, Israel c Department of Otolaryngology Head and Neck Surgery, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84101, Israel d Department of Oral and Maxillofacial Surgery, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84101, Israel Abstract Lipomas are common soft-tissue tumors but occur infrequently in the oral region. Here, we present 58 new cases of oral lipoma (OL), their clinical features, diagnostic workup, and management. The records of 58 patients with OL were reviewed. Demographic data, presenting symptoms, primary tumor site, histopathology, and clinical management were analyzed. Extraoral and intraosseous lesions were excluded. The patients were 29 men and 29 women with mean age of 59.7 years, range, 11 to 98 years. Tumor sites included the buccal mucosa (n = 31), tongue (n = 10), lip (n = 6), floor of the mouth (n = 6), and vestibule (n = 5). The mean tumor size was 2.1 cm (range, 0.3- 5.0 cm). The mean tumor duration before excision was 2.6 years (31.2 months), ranging from 2 months to 12 years. Most common presenting symptom was an asymptomatic, circumscribed mass. Histologically, the tumors were classified as classic lipoma (n = 28), fibrolipoma (n = 19), intramuscular lipoma (n = 4), minor salivary gland lipoma (n = 2), angiolipoma (n = 2), and spindle cell lipoma (n = 3). A case of spindle cell lipoma affecting the lower lip that has not been described previously is presented. The provided treatment was surgical excision. Although uncommon, OL are most common in adults and very uncommon in children. No sex predilection was found. The buccal mucosa region is the most common site followed by the tongue. Classic lipomas are most common in the oral region and comprise 48% of the tumors. A case of spindle cell lipoma of the lower lip is reported. Its clinical, histologic, and cytogenetic workup is the first well-documented case. Further cytogenetic studies should be undertaken to learn more about the pathogenesis and tumorigenesis of OL. © 2011 Elsevier Inc. All rights reserved. Keywords: Lipoma; Adipose tissue; Jaw; Mouth; Intraoral neoplasm 1. Introduction Lipomas are common, benign, slow-growing, soft tissue neoplasms of mature adipocytes; however, they are relatively uncommon in the oral region. The incidence of oral lipoma (OL) is thought to be 1% to 4% of all benign oral lesions [1]. Oral lipomas have been reported to occur in a variety of locations including the salivary glands, buccal mucosa, gingiva, lip, tongue, and floor of the mouth. It appears as a single or lobulated long-standing painless lesion with either a sessile or a pedunculated base. Oral lipoma is yellowish and soft to palpation, covered by normal mucosa. Histologically, OL can be classic lipoma, fibrolipoma, spindle cell lipoma, angiolipoma, salivary gland lipoma, pleomorphic lipoma, or atypical lipoma [2]. The purpose of this manuscript is to present 58 new cases of OL and their clinical features and management. 2. Patients and methods During the 20-year period, 1990 to 2010, 58 patients with the diagnosis of OL were treated at the Department of Oral and Maxillofacial Surgery. The tumors were classified Available online at www.sciencedirect.com Annals of Diagnostic Pathology 15 (2011) 257 – 261 ⁎ Corresponding author. Tel.: +972 6486411; fax: +972 8 640 3651. E-mail address: lbodner@bgu.ac.il (L. Bodner). 1092-9134/$ – see front matter © 2011 Elsevier Inc. All rights reserved. doi:10.1016/j.anndiagpath.2011.01.003