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. 2020 Nov 23;42(1):38.
doi: 10.1186/s40902-020-00281-4.

Treatment of intramuscular lipoma of tongue with enveloped mucosal flap design: a case report and review of the literature

Sung-Hwi Hur  1 , Jae-Seok Lim  2 , Sun-Gyu Choi  1 , Ji-Yeon Kang  3 , Ji-Hye Jung  1 , Eun-Young Lee  4   5
Affiliations

Treatment of intramuscular lipoma of tongue with enveloped mucosal flap design: a case report and review of the literature

Sung-Hwi Hur et al. Maxillofac Plast Reconstr Surg. .

Abstract

Background: Lipomas are benign soft tissue neoplasms of mature adipose tissue commonly occurring in the trunk or extremities. But, intraoral lipomas are rare entities which may be only noticed during routine dental examinations. Especially intramuscular lipomas on the tongue have been reported very rarely. In this study, we report a case of intramuscular lipoma on tongue, with a review of the literature from 1978 to 2019, providing data on age, gender, location, presenting symptoms, size, surgical methods, and recurrence.

Case presentation: A case of intramuscular lipoma occurring in tongue region in a 65-year-old male is reported. Surgical excision is the mainstay of treatment for the lesion. In order to decrease the deformity and discomfort after the excision, we tried to modify surgical technique using enveloped mucosal flap. This technique provided more comfortable healing procedure on the operative site without recurrence.

Conclusion: This is a rare case of large intramuscular lipoma on tongue. Surgical excision with enveloped mucosal flap design was performed to diminish postoperative raw surface and discomfort and a 24-month follow-up showed excellent healing without any recurrence. A case of intramuscular lipoma on tongue and relevant literature reviews are presented in this study.

Keywords: Enveloped mucosal flap; Excision; Intramuscular lipoma; Lipoma; Tongue.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a, b. A painless mass on the right lateral border of tongue
Fig. 2
Fig. 2
MRI showing a submucosal swelling within the muscles of the tongue on Rt. lateral side (white arrows)
Fig. 3
Fig. 3
a The flap was designed as an envelope form (incision line-white arrows). b Surgical excision toward muscle side was done (white arrow). Then, the preserving mucosal flap was sutured to its original position (black arrows)
Fig. 4
Fig. 4
The size of the tumor was 2 × 4 × 1.5 cm, surrounded by 0.1–0.3 cm yellow fat granules
Fig. 5
Fig. 5
Histopathological features of the mass. a Adipocytes are seen diffusely infiltrating adipocytes the skeletal muscle (H and E stain, original magnification × 50). b Microphotograph showing mature fat cells with nuclei peripherally located (H and E stain, original magnification × 200)
Fig. 6
Fig. 6
a Tumor was surgically excised with restoration of normal tongue function and aesthetic appearance. Two weeks after the operation, healed well without any complications. b After 3 months, the aesthetic appearance of the tongue was well restored and no recurrence was seen
See this image and copyright information in PMC

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