Case report Well-differentiated liposarcoma of the tongue F.D.Nunes,S.V.L.Loducca,E.M.F.deOliveira,V.C.deArau´jo* Disciplina de Patologia Bucal, Faculdade de Odontologia, Universidade de Sa ˜o Paulo, Av. Prof. Lineu Prestes, 2227, Butanta ˜, CEP 05508-900, Brazil Received 23 January 2001; accepted 19 February 2001 Abstract Intraoral liposarcomas are rare, with most reported cases being of the myxoid histological type. We present a well-differentiated liposarcoma of the tongue, in a 65-year-old man. The tumour presented lipoblasts in various stages of differentiation, lipocytes in different sizes and shapes, mesenchymal and signet-ring cells. Lipoma, spindle-cell lipoma, myxoma, hibernoma, angiolipoma, fibrolipoma, pseudosarcomatous faciitis and malignant hysticytoma were considered in the diagnosis process. The patient was treated surgically and so far is free of disease. # 2002 Elsevier Science Ltd. All rights reserved. Keywords: Well-differentiated liposarcoma; Oral cavity; Tongue 1. Introduction Liposarcoma is one of the most common soft tissue sarcomas of adult life [1,2]. Lower extremities and ret- roperitonium are the sites of greater incidence of this mesenchymal tumour [1]. Head and neck liposarcomas are unusual and intra-oral examples are exceedingly rare [3]. To our knowledge there are only a few cases reported in English literature, most of them being of the myxoid type. This report presents a case of a well- differentiated liposarcoma arising in the tongue. 2. Case report A65-year-oldblackmanpresentedwithahistoryofa smallpainlessmassof3-yeardurationonthedorsalapex of the tongue. At physical examination a firm nodular, slightly tender submucosal mass, measuring approxi- mately 10 mm in diameter was observed. There was no evidence of colour alteration in the lining mucosa. Extraoral examination revealed palpable, soft and mobilenodesontherightanteriorandleftposteriorcer- vicalchains,compatiblewithmildlymphadenitis.Medi- calhistorywasuneventful.Withaclinicalhypothesisof fibroma,anexcisionalbiopsywasperformedandsentto the Surgical Pathology Service of the Oral Pathology Department, University of Sa˜o Paulo Dental School. 3. Gross findings At gross examination, the formalin-fixed specimen consistedofawhitishsoftfibro-elastictissue,measuring 10Â10Â7 mm. The material was routinely prepared for light microscopy. 4. Microscopic findings Microscopic examination of the haematoxylin/eosin stained sections showed thinned stratified squamous epithelium over the surface. The submucosa revealed a non-encapsulated mesenchymal tumour extending to the epithelial level (Fig. 1A). The tumour was characterised by well-differentiated lipoblasts, arranged in lobules interspersed by dense fibrous bundles. Individually, the cells were vacuolated, containing varying amounts of lipid droplets, and displaying hyperchromatic, peripheral, and pleomorphic nuclei. Small, scattered nests of multi- vacuolatedlipoblastswerealsonoted.Signet-ringcellswere present,filledwithasinglelargelipidglobule,andshowing a lateral displacement of the nucleus. Mitotic figures were not observed; however, lipoblasts in several stages of dif- ferentiation were abundant (Fig. 1B). Discrete inflamma- tory infiltrate and neurofibro-vascular elements could 1368-8375/02/$ - see front matter # 2002 Elsevier Science Ltd. All rights reserved. PII: S1368-8375(01)00030-6 Oral Oncology 38 (2002) 117–119 www.elsevier.com/locate/oraloncology * Corresponding author. Tel./fax: +55-11-818-7902. E-mail address: vcaraujo@siso.fo.usp.br(V.C.deArau´jo).