Pathognomonic Features in Lipoma of the Tongue

Case Summary

A 55-year-old female patient presented with swelling in the right side of her tongue gradually increasing in size over the past 15 days. Otherwise, she was asymptomatic.

The patient was a habitual betel nut chewer.

On local examination, a 2 × 2 cm globular swelling was noted in the right lateral border of the tongue. No other lesions were noted. No palpable cervical lymphadenopathy.

A contrast-enhanced computed tomography (CT) scan of the neck showed an 11 (anteroposterior) × 16 (transverse) × 12 (craniocaudal) mm, well-defined fat density lesion in the anterior third of the tongue (along the right lateral border) with no obvious enhancement. The rest of her tongue was normal. No notable cervical lymphadenopathy was observed. The lesion was excised from the patient under local anesthesia. The patient is currently on follow-up and doing well.

Fig. 1 Preoperative image showing a mass and intraoperative image showing an ovoid encapsulated yellow soft tissue mass with smooth external surface in the right lateral border of tongue.

It is difficult to make a clinical diagnosis of oral lipoma because of the possibility of diagnosis of various benign tumors including mucocele, encapsulated abscess, lipoma, neuroma, rhabdomyoma, neurofibroma, fibroma, or salivary gland tumor.

Macroscopically, the lesion measured 2 ×1.5 × 1 cm. The lesion was an encapsulated yellow soft tissue, ovoid, and with a smooth external surface ([Fig. 1]).

Microscopically, a thin fibrous capsule is seen. The tumor shows lobular architecture separated by variably thick fibrovascular septa.[1] These tumor cells are mature adipocytes with small eccentrically placed nuclei where the nuclei are often compressed ([Fig. 2]) with no notable inflammation, or cellular atypia, lipoblasts, or features of malignancy. Thus, final diagnosis was histopathologically confirmed as lipoma.

Fig. 2 Microscopically the sections showing sheets and lobules of benign adipocytes separated by variably thick fibrovascular septa. Focally, the adipocytes are seen to infiltrate around skeletal muscle tissue.

Author's Contributions

M.N. conceptualised the study, reviewed the manuscript and he is the guarantor. R.B. designed the study, defined intellectual content, performed literature review, prepared and edited the manuscript. R.M and V.C.K. reviewed the manuscript.

Publikationsverlauf

Artikel online veröffentlicht:
07. Juli 2025

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