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. 2019 May 1;24(3):e373-e378.
doi: 10.4317/medoral.22931.

Intraoral lipomas: A clinicopathological study of 43 cases, including four cases of spindle cell/pleomorphic subtype

M-F Linares  1 , A-C-L-S Leonel, E-J-A Carvalho, J-F-L de Castro, O-P de Almeida, D-E-C Perez
Affiliations

Intraoral lipomas: A clinicopathological study of 43 cases, including four cases of spindle cell/pleomorphic subtype

M-F Linares et al. Med Oral Patol Oral Cir Bucal. .

Abstract

Background: The aim of this study was to describe the clinicopathological characteristics of 43 intraoral lipomas and classify them according to their microscopic variants.

Material and methods: All the cases of intraoral lipomas diagnosed at an Oral Pathology service were selected for the study. Clinical data, such as age, gender, location, time of evolution, clinical presentation, clinical hypothesis of diagnosis, and treatment, were collected from the clinical files.

Results: Of the 43 cases analyzed, 24 (55.8%) occurred in women. The mean age was 77.4 years. The most affected site was the buccal mucosa (22 cases, 51.1%). The mean lesion size was 1.7 cm. Twenty-three cases (53.5%) were classified as simple lipoma, 14 (32.6%) as fibrolipoma, four (9.3%) as spindle cell/pleomorphic lipoma (SC/PL), one (2.3%) as lipoma of the salivary glands, and one (2.3%) as intramuscular lipoma. In one case of SC/PLs, lipoblasts were observed. No atypical lipoblasts or mitoses were noted. Lipoma was considered more often than other tumor histological subtypes among the clinical hypotheses of diagnosis when the final diagnosis was simple lipoma (p=0.01).

Conclusions: Intraoral lipomas present different clinical presentation depending on the histological subtype. In SC/PLs, lipoblasts with vacuolated cytoplasm may be found and the presence of mature adipocytes is essential for diagnosis.

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Conflict of interest statement

Conflict of interest statement:The authors have declared that no conflict of interest exists.

Figures

Figure 1
Figure 1
Macroscopic aspect of an oral lipoma of the buccal mucosa presenting as nodular and pedunculated lesion.
Figure 2
Figure 2
Microscopic features of histological subtypes of lipomas of the mouth. A, Panoramic view of a well-circumscribed nodular lesion, located adjacent to the oral epithelium (HE, 10x). B, Mature adipocytes interspersed by dense and thick bundles of fibrous connective tissue, characterizing a fibrolipoma (HE, 100x). C, Simple lipoma presenting well- differentiated adipocytes (HE, 200x). D, Intramuscular lipoma showing well-differentiated adipocytes interspersed by skeletal muscle fibers (HE, 200x).
Figure 3
Figure 3
Microscopic and immunohistochemical features of spindle cell/pleomorphic lipoma. A, Mature adipocytes in varying sizes interspersed by bland spindle cells arranged in a loose stroma (HE, 100x). B, High-power view of the features observed in A (HE, 200x). C, Presence of lipoblasts, one of them vacuolated (arrow), well-differentiated adipocytes, and spindle cells arranged in a fibrous connective tissue (HE, 400x). D, Spindle cells positive for CD34 (streptavidin-biotin-peroxidase method, 200x). E, Spindle cells negative for S-100 protein. Note positivity only in mature adipocytes (streptavidin-biotin-peroxidase method, 400x). F, Less than 1% of Ki-67-positive tumor cells (streptavidin-biotin-peroxidase method, 200x).
See this image and copyright information in PMC

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