Large Lipoma of the Mouth Floor

Abstract

Lipomas are one of the most common benign connective tissue masses in the human body. They rarely cause issues and are typically removed for cosmetic reasons. They rarely appear in the oral cavity though they are common. Thus, only a few sublingual lipoma cases have been reported. We present a case of a male in his 60s who came to our clinic complaining of dysphagia and dysarthria caused by an oral swelling from a right sublingual simple lipoma. It was decided to be removed surgically under general anesthesia, with neuromonitoring of the right hypoglossal nerve. The patient tolerated the surgery without complications and fully recovered with complete resolution of his mass effect symptoms. This case demonstrated the importance of having a wide differential diagnosis of oral lesions, especially in a patient with a complicated medical history. Though it is not used often, the case also demonstrated the neuroprotective effect of intraoperative hypoglossal nerve monitoring during sublingual surgeries.

Large Lipoma with Focal Cartilage Metaplasia of the Under-tongue Region

“…K. Gibson et al described another similar clinical case; they reported a case of a large lipoma of the mouth floor (8.5 × 4.0 × 1.0 cm), excised with neuromonitoring of the right hypoglossal nerve, with a definitive histological diagnosis of simple lipoma without invasion of the surrounding tissues; no focal cartilage metaplasia was described 4 …”

“…10 K. Gibson et al described another similar clinical case; they reported a case of a large lipoma of the mouth floor (8.5 × 4.0 × 1.0 cm), excised with neuromonitoring of the right hypoglossal nerve, with a definitive histological diagnosis of simple lipoma without invasion of the surrounding tissues; no focal cartilage metaplasia was described. 4 Differential diagnoses are very important and physician should base their considerations on patients' history and physical examination, imaging, and pathological findings.…”

“…3 A large size neoformation in the floor of the mouth may interfere with speaking, swallowing, and breathing (causing dysarthria, dysphagia, or dyspnea), but lipomas are usually asymptomatic. [1][2][3][4][5][6][7] Furthermore, lipomas can be classified based on their histological cell composition, presence or absence of encapsulation, and presence or absence of nearby tissue invasion. Simple lipomas make up 53.5% of fatty oral benign lesions.…”

“…A large size neoformation in the floor of the mouth may interfere with speaking, swallowing, and breathing (causing dysarthria, dysphagia, or dyspnea), but lipomas are usually asymptomatic 1–7 …”