Oral Soft Tissue Lipomas and Related Tumors

Oral soft tissue lipomas are benign mesenchymal neoplasms composed predominantly of mature adipocytes. Although lipomas represent the most common soft tissue tumour in the body, only 1–5% occur within the oral cavity, typically presenting as slow-growing, painless swellings. The most frequent sites include the buccal mucosa, tongue, and floor of the mouth. Histological variants encompass simple lipomas, fibrolipomas, spindle cell lipomas, angiolipomas and chondrolipomas; each subtype exhibits characteristic proportions of adipose tissue, fibrous stroma or vascular elements. Intraosseous counterparts arise within mandibular or maxillary bone and are exceedingly rare, often discovered incidentally on radiographic examination. Diagnosis hinges on clinical examination supplemented by imaging and histopathological analysis to exclude liposarcoma and other radiolucent lesions. Conservative surgical excision remains the treatment of choice, yielding excellent prognoses with minimal risk of recurrence. Recent advances in immunohistochemical profiling and molecular analysis have refined our understanding of pathogenesis and subtype classification, with practical implications for diagnosis and management. Understanding the diverse histological presentations and radiographic appearances is crucial for accurate differential diagnosis, ensuring effective surgical planning and patient counselling.

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Recent clinicopathological analysis of 91 intraoral lipomas diagnosed over a 14-year period has provided the largest single-centre dataset to date, confirming a slight female predominance and mean lesion size of approximately 16 mm. Buccal mucosa remained the most affected site, while fibrolipomas appeared more frequently in women and tended toward smaller dimensions. Statistical comparisons highlighted the influence of histological subtype on clinical presentation, underscoring the importance of subtype-specific diagnostic criteria.

A 2022 case series described an intraosseous lipoma mimicking a periapical lesion of the maxilla. Radiographic evaluation revealed a well-circumscribed radiolucency adjacent to a non-vital tooth, initially presumed to be an abscess. Histopathological examination following extraction and curettage confirmed adipose tissue proliferation without atypia. This work emphasises the necessity of histopathological assessment in atypical periapical radiolucencies and raises awareness of intraosseous lipomas as a potential diagnostic pitfall in routine dental practice.

Investigation into sialolipoma of the floor of the mouth has delineated this rare variant in which mature adipocytes entrap salivary glandular tissue. Immunohistochemical characterisation has revealed co-expression of adipocyte markers and cytokeratins within glandular elements, distinguishing sialolipoma from other lipomatous lesions. The study confirmed conservative excision as curative and highlighted the need for pathologists and surgeons to recognise this subtype to avoid misdiagnosis as salivary neoplasm.

Oral Soft Tissue Lipomas and Related Tumors publication trend

The graph below shows the total number of articles in oral soft tissue lipomas and related tumors across all publications each year (not limited to Nature Index journals).

Technical terms

Lipoma: A benign tumour composed of mature adipocytes.

Fibrolipoma: A lipoma variant containing abundant fibrous connective tissue alongside adipocytes.

Sialolipoma: A lipoma subtype that incorporates salivary gland elements within the adipose mass.

Mesenchymal neoplasm: A tumour arising from mesenchyme-derived tissues such as fat, muscle or bone.

Curettage: Surgical removal of tissue by scraping or scooping, often used for intraosseous lesions.

Histopathology: Microscopic examination of tissue to study the manifestations of disease.

References

1. Intraoral soft tissue lipomas: clinicopathological features from 91 cases diagnosed in a single Oral Pathology service. Medicina Oral Patología Oral y Cirugia Bucal (2021).
2. Intraosseous Lipoma Mimicking Periapical Lesion: A Rare Presentation. Case Reports in Dentistry (2022).
3. Sialolipoma of the Floor of the Mouth with Immunohistological Analysis. Case Reports in Dentistry (2021).