Oral Lipoma: A Non Cancerous Tumor

What Are Oral Lipomas?

Lipomas generally are benign fatty tumors and, in fact, are the most common sort of mesenchymal neoplasms. Lipomas are prevalent globally, and in most cases, they occur more on the trunk or on the proximal portions of the body's extremities. Though medical literature does not elucidate much on the occurrence of oral lipomas as the observation of lipomas in the oral and maxillofacial region are rare but not absent. The dentist must also rule out other similar conditions and arrive at a confirmatory diagnosis to plan the treatment accordingly.The malignant counterpart of this benign tumor is called liposarcoma. But the occurrence of this oral soft tissue malignancy (liposarcoma) is a rarity within the oral cavity.

What Are the Causes of Oral Lipomas?

The common causes of lipomas are enlisted as follows. These include

• Heredity or genetic origins.

• Fatty degeneration of oral mucosa.

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• Hormonal abnormalities impacting the oral mucosal membrane.

• Injuries or traumatic impact.

• Systemic infections.

• Muscle cell metaplasias (an abnormal change in the tissue’s nature).

• Deposition of residual embryonic fat cells.

• Chronic (long-term) irritation of the oral mucous membranes.

What Are the Clinical Characteristics of Oral Lipomas?

Most cases of lipoma are reported after the sixth decade of life or in older individuals, with a mean age of incidence at 60 years. Lipomas of the oral cavity are rare in children. According to reports, oral lipomas tend to occur in different anatomical sites, such as in the major salivary glands, on the soft tissues like buccal mucosa, lip, tongue, palate, and on the floor of the mouth. The commonly reported intraoral sites are lesions on the buccal mucosa or the buccal vestibule. Patients suffering from these uncommon oral lipomas may have painless or slow-growing asymptomatic lesions for months or even years. Lipomas are usually asymptomatic but may eventually interfere with speech and mastication as they grow larger. That is when the patient complains of the lesion's interference. However, on clinical examination, these lesions appear yellowish with a soft, doughy consistency. They are also well-defined, and lesions may be fluctuant and nodular in some cases.

How Are Oral Lipomas Diagnosed?

Radiographically, computer tomography (CT uses specialized X-rays to view the cross-sectional images of the organs present inside), magnetic resonance imaging (MRI uses a combination of magnetic field and radiowaves to get detailed images), or cone beam computed tomography (CBCT) would give a confirmatory diagnosis for these well-defined lesions. Histopathologic and radiographic observations should be cross-checked before establishing a diagnosis.

What Are the Risk Factors for Oral Lipomas?

According to research, irrespective of the cause, most patients commonly report systemic diseases with oral lipoma without any familial inheritance patterns. Also, unlike other oral cavity tumors, specific predisposing events or risk factors such as smoking or chronic alcoholism do not exist. As per evidential case reports, most or all lipomas tend to be more common in females, and the prevalence rates are usually equal in both histologic variants of oral classic and fibro-lipomas. An increased male preponderance exists for classic lipomas, while an increased female preponderance exists in the case of fibro-lipomas.

What Are the Histopathological Features of Oral Lipomas?

Microscopically, it is difficult to differentiate between lipoma and normal adipose tissue. Oral lipomas usually show a well-lobulated appearance with clear far cells and are not encapsulated; instead, there will be aggregates of mature adipocytes, clear cytoplasm, and absence of vascularity, all of which are confirmative of a classic oral lipoma. Histologically, lipomas would be classified based on the histopathological features as classic lipomas or the variants of classic lipoma like fibro-lipomas, intramuscular lipomas, angiolipomas, pleomorphic lipomas, myxoid lipomas, spindle lipomas, atypical lipomas and salivary gland related lipomas.

What Is the Management of This Benign Tumor?

Management of the tumor depends on the extent, location, and diameter of the lesion. Rarely do they exceed 25 millimeters in diameter, so most of the lesions would be small to moderate size. These oral cavity lesions are treated by the maxillofacial surgeon or the dentist conservatively through local excision. Oral lipomas do not have any post-operative healing complications, and recurrences are extremely rare, so the post-excision prognosis is excellent.

Conclusion

Oral lipomas are benign lesions or mesenchymal-origin primarily composed of fat cells. The dentist can treat these lesions with surgical excision, and treatment has an excellent prognosis.

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