CASE REPORT Angiofibrolipoma of the oral cavity Apostolos Epivatianos 1 , Alexandros Kolokotronis 1 , Apostolos Matiakis 2 & Athanasios Poulopoulos 1 1 Department of Oral Medicine and Oral Pathology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece 2 Private Practice, Thessaloniki, Greece Introduction Lipomas are benign mesenchymal neoplasms composed of mature adipocytes, usually encapsulated. Although they are the most common soft tissue tumor, only 1–4% of cases occur in the oral cavity. 1 Based on their histopatho- logical features, lipomas can be classified in different vari- ants. 2 A rare histological variant, angiofibrolipoma, has been described in the English literature. 3 A literature search revealed only seven references of angiofibrolip- oma, 3–9 most of which are not English-language publica- tions. All these cases of angiofibrolipoma were located in different anatomical sites, and no case in the oral cavity has been previously reported. Therefore, in the present study, we present a case of angiofibrolipoma affecting the alveolar mucosa of the oral cavity. Materials and methods A 42-year-old man was referred by his dentist in April 2008 to the Department of Oral Medicine and Oral Pathology at the dental school of the University of Thes- saloniki, Thessaloniki, Greece for evaluation of asymp- tomatic swelling in the alveolar mucosa adjacent to the left upper canine and first left upper premolar. The swell- ing was noticed 2 weeks earlier. The medical and family histories of the patient were unremarkable. Clinical exam- ination showed a firm, sessile, well-circumscribed swelling with a diameter of 0.8 cm, covered by normal mucosa (Figure 1a). No pathological radiographic findings were observed, and the teeth adjacent to the swelling were unaffected. Under local anesthesia, excisional biopsy was carried out with clear margins of healthy tissue. The wound was then closed, and the healing was uneventful. One year of follow up showed no evidence of recurrence. The patient gave informed consent, and the whole study was performed according to the Declaration of Helsinski. Results An histological examination of the lesion showed it to be composed of mature adipocytes, collagen fibers, and blood vessels of different sizes. Some blood vessels con- tained fibrin thrombi, whereas many small capillaries were compressed by collagen fibers and adipocytes (Figure 1b). The lesion was not encapsulated, but was histologically distinct from surrounding connective tissue. Mitotic figures and atypia were not observed. Additional sections Keywords CD-34, histological, immunohistological, lipoma oral angiofibrolipoma. Correspondence Assistant Prof. Athanasios Poulopoulos, Department of Oral Medicine and Oral Pathology, Dental School, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece. Tel: +302310-999528 Fax: +302310-999455 Email: akpoul@yahoo.gr Received 24 November 2009; accepted 1 February 2010. doi: 10.1111/j.2041-1626.2010.00003.x Abstract We describe an unusual and rare case of a lipoma variant known as angiofibro- lipoma. A literature search revealed only a few cases of angiofibrolipoma which were located in different anatomical sites; no case of angiofibrolipoma in the oral cavity has been previously reported. We present and discuss the histo- patholological–immunohistological findings and features. Angiofibrolipoma histologically consists of mature adipocytes, blood vessels, and bundles of collagenous connective tissue with low to moderate cellularity. It is not encap- sulated, but is histologically distinct from surrounding tissue. Positive immuno- histological staining with CD-34 presented a large number of blood vessels of different sizes located between collagen fibers and adipocytes. The treatment of choice for a patient with angiofibrolipoma is surgical excision, which is expected to be curative. Journal of Investigative and Clinical Dentistry (2010), 1, 47–49 ª 2010 Blackwell Publishing Asia Pty Ltd 47