Lipoma is the most common benign mesenchymal tumor of soft tissues in humans. It occurs mainly in the trunk, in the extremities of the body and in the neck region, but only 0.1 to 5% are in the oral region. Clinically, the lesion located in the oral cavity is well-defined, asymptomatic, and the color varies according to its distribution in the oral tissues. They may be sessile or pediculated, with a smooth surface, gelatinous appearance, and may vary in size. The treatment commonly indicated consists of total excision of the lesion, which is an essential factor for the success of the treatment. The objective of this study is to report and discuss a case of lipoma located in the oral space, treated surgically with intraoral access under local anesthesia and in an outpatient setting.
Lipomas are benign soft tissue tumors, originating from the mesenchyme and are consisting of mature adipocytes. Although it is the most common type of mesenchymal neoplasia, only about 20% of these tumors affect the head and neck and of these, only 0.1 to 5% are in the oral cavity
Regarding their etiology and pathogenesis, although uncertain, they seem to be associated with inflammatory, endocrine, trauma and genetic factors, affecting more commonly female patients, when related to the oral cavity, between the 5th and 7th decade of life
When they affect the oral cavity, in most cases, they appear in the region of the jugal mucosa, followed by the lip, retromolar region and tongue
The diagnosis can be confirmed by means of histopathological analysis, after excisional biopsy of the lesion. An important factor for differential diagnosis with other neoplasms is related to the fact that the surgical specimen floats under a 10% formaldehyde solution, due to the high concentration of fat
Therefore, the aim of this study is to report and discuss a clinical case of lipoma in the oral space, which was conducted in an outpatient setting under local anesthesia.
Excisional biopsy of the lesion was instituted as treatment. After asepsis and antisepsis with chlorhexidine, the patient was anesthetized with 2% lidocaine and epinephrine 1: 200,000. Initially, aspiration puncture was performed, with a negative result for liquid content. Thus, an incision was made in the left cheek mucosa, followed by divulsion to expose the lesion. After excision of the tumor, copious irrigation with 0.9% saline solution was performed. The sutures were performed with 4-0 nylon thread (
The surgical specimen was stored in a solution with 10% formaldehyde, demonstrating the ability of the lesion to float, corroborating the clinical suspicion (
Lipomas are benign neoplasms, originating from adipose tissue and are commonly found on the trunk, extremities of the human body and neck
Although its etiopathogenesis remains uncertain, trauma and chronic irritation seem to play an important role in the development of a lipoma
Due to the location and clinical aspects of the lesion, it was possible to assess and suspect its diagnosis through clinical examination, eliminating the need for complementary tests in this case. However, if the clinical examination is not enough to identify the limits of the pathology, it is prudent to request imaging tests, such as ultrasound, computed tomography or magnetic resonance, as complementary tests
Lipomas can present as painless nodular masses, usually yellowish, which may be sessile or pediculated, with a flat surface, gelatinous appearance and well circumscribed
In general, surgical removal of the lesion can be performed in an outpatient setting or in an operating room, depending on the systemic conditions and collaboration of the patient, size, location and depth of the lesion. Rarely, lipomas are larger than 5 cm in diameter, the majority being in the orofacial region of up to 2 cm
After the lipomas are excised, if well performed, it presents with a good prognosis and without relevant incidences of malignant transformation
Although lipoma is the most common mesenchymal neoplasm in humans, only 15% to 20% occurs in the head and neck and when associated with the oral cavity, it most commonly affects the jugal mucosa. They are characterized by benign lesions, slow growth, well defined and with low rates of recurrence, therefore, they present with a favorable prognosis. Despite this, its growth in the oral region directly interferes with the functions of the stomatognathic system, such as phonation, chewing and adaptation of removable prostheses. Even with histological variations, the most appropriate treatment consists of total excision of the lesion, which is an essential factor for the success of the treatment.