International Journal of Clinical Case Reports 2015, Vol.5, No. 35, 1-4
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lymphoepithelial cyst were considered in differential
diagnoses. Routine blood investigations failed to
reveal any significant finding as blood parameters
were within normal limits. The lesion was excised and
sent for histopathological examination which revealed
proliferation of mature adipocytes arranged in lobules
and separated by fibrous septa (Figure 2). Based on
the clinical and histopathological findings, a final
diagnosis of lipoma was eventually arrived-at.
Discussion
The first discussion of oral lesions was provided by
Roux in 1948. In his review of alveolar masses, Roux
referred to the oral lesions of lipoma as “yellow
epulis” (Rajendran and Sivapathasundharam, 2009).
Oral lipomas are usually soft, smooth-surfaced,
nodular masses that can be sessile or pedunculated.
Figure 1 Revealing a pinkish nodular growth in relation to right
anterior buccal mucosa
Figure 2 Revealing proliferation of mature adipocytes arranged
in lobules and separated by fibrous septa on histopathological
examination
Typically, the tumour is asymptomatic and of a
multiple or more subtle, but obvious yellowish hue.
Oral lipomas, more deeply rooted in the tissue, may
appear pink. The various types of oral peripheral
mesenchymal tumours as classified by Furlong et al
include (Rajendran and Sivapathasundharam , 2009)
Lipomas;
Myomas ( rhabdomyomas and leiomyomas); and
Peripheral nerve tumours (neurofibromas, plexiform
type of neurofibromas, schwannomas, and traumatic
neuromas).
Morphologically, Rajendran and Sivapathasundharam
(2009) classified intra-oral lipomas as
Superficial forms;
Diffuse forms, affecting the deeper tissues; and
Encapsulated forms.
Accounting for 50% of all the reported cases, the
buccal mucosa and buccal vestibule are the most
common intra-oral sites. Freitas et al.
(2009) reviewed
26 cases of intra-oral lipomas out of which, the classic
lipoma was the most common in 15 cases, followed
by fibrolipoma for which 7 cases were reported. In a
review conducted in a Brazilian population by
Fregnani et al.,
(2003), classic lipomas followed by
fibrolipomas again represented the lesions most
commonly diagnosed as intra-oral lipomas. Oral
lipomas located on the buccal mucosa may not
represent true tumour, but rather herniation of buccal
fat pad through the buccinators muscle. Such cases
may occur subsequent to a local trauma in young
children or the surgical removal of third molar in
elderly patients. Less common sites include the tongue,
floor of mouth and lips
(Neville et al., 2009).
Analyzing 125 lipomas of the maxillofacial region, it
was found that parotid region was the site most
prevalent followed by buccal mucosa, lip, submandibular
region, tongue, palate, floor of the mouth and buccal
vestibule, in that order of decreasing incidence
(Furlong et al., 2004). A case of intra-osseous lipoma
in the mandible in a female patient has also been
reported in the literature and the occurrence is even
rare (Buric et al., 2001; Pass et al., 2006). Regarding
gender, according to literature, intra-oral lipomas have
no gender predilection, but meanwhile there are
greater tendencies for males
(Furlong et al., 2004;
Bandeca et al., 2007; Trandafir et al., 2007). The
lesion is usually non- tender, soft and almost cheesy in
consistency but may be fluctuant. It is typically
