A 37 mm Spindle Cell Lipoma on the Floor of the Mouth

Abstract

Spindle cell lipoma (SCL) is a rare variety of lipoma that mostly arises in male patients and rarely affects the oral cavity. The floor of the mouth is an uncommon site for SCL, and very few cases have been reported in this location. A case of SCL is reported in a 70-year-old woman who had noticed a swelling of the floor of the mouth without any functional consequence. Both ultrasonography and RMI suggested a diagnosis of ranula, whereas clinical palpation showed a nonfluctuant mass. The lesion was excised under local anesthesia. A 37×32 mm encapsulated yellow mass was removed. Histological features (mature adipocytes and CD34+ spindle cells) led to a diagnosis of SCL. Medical imaging assessment of this lesion could have been influenced by the high frequency of the ranulas in the floor of the mouth. This case appears to be quite infrequent because of its location (floor of the mouth), its size (over 3.5 cm), and the patient’s gender (female).

Large intraoral spindle cell lipoma

“…Originally, SCL and pleomorphic lipoma, another subtype of lipoma, were described as two separate lesions, but they are now considered to be a spectrum of the same entity ( 9 ). Intraoral SCL shows a predilection for males ( 1 , 2 , 10 - 13 ) and most affected patients are adults in their fourties to fifties, being rare in childrens and adolescents ( 1 , 10 - 14 ). SCL manifesting in the oral and maxillofacial region can affect several anatomical locations, including major salivary glands and the oral cavity ( 3 ).…”

“…Most intraoral SCL are relatively small painless lesions measuring less than 4.0 cm, and presenting as a well-circumscribed sessile nodule ( 1 , 9 - 11 , 13 , 14 ). The present case highlights an uncommon clinical presentation for intraoral SCL, as a 5.0 cm pedunculated growth.…”

“…Another interesting feature in the present case is the presence of ulceration. Clinical differential diagnosis of intraoral SCL is dependent on the anatomical location of the tumor and can include salivary gland tumors, benign mesenchymal neoplasms, mucous extravastion phenomena and mucous cysts ( 11 , 13 ). If one includes a salivary gland tumor and/or a mesenchymal neoplasm in clinical differential diagnosis and the lesion is ulcerated, malignant entities should be also considered.…”

Lipomas: A Case Series

“…22 Differential diagnosis of spindle cell lipoma includes schwannoma, neurofibroma, leiomyoma, solitary fibrous tumour, liposarcoma and dermatofibrosarcoma tuberans. 12 Odontogenic cyst, ameloblastoma, osteoblastoma, chondrosarcoma, liposarcoma, hemangioma, arteriovenous malformation, simple bone cyst, aneurysmal bone cyst and central giant cell granuloma must be considered in the differential diagnosis of intraosseous lipomas. 2,6 Multiple lipomas can be seen in the presence of hereditary diseases such as familial multiple lipomatosis, benign symmetrical lipomatosis, Cowden syndrome (Multiple Hamartoma Syndrome), Adiposis dolorosa (Dercum's disease), Proteus syndrome.…”

“…Simple lipoma is the most common type. 12,13 In this report, our aim is to present 5 cases of intraoral lipoma with clinical findings, surgical treatment and histopathological features.…”