|Year : 2017 | Volume
| Issue : 1 | Page : 50-51
Huge lipoma of soft palate: A common disease at an uncommon anatomi-cal site
R Sinha1, RK Singh1, KH Raghwendra2, A Singh3, RN Biswas4
1 Department of Otorhinolaryngology, Indira Gandhi institute of Medical Sciences, Patna, lndia
2 Department of Anesthesiology, Indira Gandhi Institute of Medical Sciences, Patna, India
3 Department of Pathology, Indira Gandhi Institute of Medical Sciences, Patna, India
4 Department of Clinical Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, Sheikhpura, Patna, Bihar, India
|Date of Web Publication||11-Dec-2020|
Department of Otorhinolaryngology, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna
Source of Support: None, Conflict of Interest: None
Lipoma is a common benign tumor com-posed of adipose tissue. Its incidence in head and neck region is 20%. However, involvement of oral cavity and moreover pal-ate is extremely rare. Usually asymptomatic, it produces symptoms when huge. We pre-sent one such rare case of huge oral lipoma located in palate and extending to tonsillar fossa.
Keywords: palate, benign, adipose, oral
|How to cite this article:|
Sinha R, Singh R K, Raghwendra K H, Singh A, Biswas R N. Huge lipoma of soft palate: A common disease at an uncommon anatomi-cal site. J Indira Gandhi Inst Med Sci 2017;3:50-1
|How to cite this URL:|
Sinha R, Singh R K, Raghwendra K H, Singh A, Biswas R N. Huge lipoma of soft palate: A common disease at an uncommon anatomi-cal site. J Indira Gandhi Inst Med Sci [serial online] 2017 [cited 2021 Dec 6];3:50-1. Available from: http://www.jigims.co.in/text.asp?2017/3/1/50/303131
| Introduction|| |
Lipoma is a common benign slow growing tumor composed of adipose tissue. Its incidence in head and neck region is 20%, but involvement of oral cavity is rare (O.5-4%). Amongst oral sites, the buccal mucosa is the most common site followed by tongue and floor of the mouth. They commonly present as asymptomatic encapsulated, soft, cystic, lobulated, smooth lesions with a characteristic yellowish color. When large, it may cause difficulty in mastication, swallowing or phonation and may cause snoring. We present one such rare case of huge oral lipoma located in palate and extending to tonsillar fossa.
| Case Report|| |
A 25 year old female presented with the chief complaint of gradually progressive swelling in the left side of palate since 1 year with difficulty in swallowing, change in voice and slight difficulty in breathing since 1 month. The medical history of this patient was insignificant except for presence of obesity. There was no history of trauma or any similar disease in family. On general and systemic examination no abnormality was detected. On intraoral examination, a well defined, soft, smooth, yellow to pinkish in color, non tender swelling of approximately 4x3 cm was noted over left side of soft palate extending inferiorly to ipsilateral tonsillar fossa causing bulging of lateral pharyngeal wall and deviation of uvula to the opposite side [Figure 1]. It was submucosally located with clearly visible overlying superficial vessels. Routine blood investigations were within normal limit. Computed tomography scan was advised which revealed well circumscribed 4x3.5 cm fat density mass lesion in oropharynx, eccentric in position from mid-line to left side, having mass effect over soft palate, pterygoid muscle and tonsillar fossa [Figure 2]. Transpalatal excision of tumor was done in toto under general anesthesia [Figure 3], followed by histopathological examination which revealed proliferations of adipocytes surrounded by a thin connective tissue capsule.
|Figure 1: smooth yellowish swelling noted over left side of soft palate extending inferiorly to ipsilateral tonsillar fossa with deviation of uvula to opposite side.|
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|Figure 2: Computed Tomography (coronal and axial view) showing well circumscribed fat density mass lesion in soft palate|
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| Discussion|| |
Lipomas are slow growing benign mesenchymal neoplasms. They are composed of adipose tissue. Therefore, their presence in oral cavity is uncommon (0.5-4%) with buccal mucosa being the most common site due to abundant fat, followed by tongue, floor of the mouth, lips and gingiva. There is very little fatty tissue in palate, so its involvement is even rare,,. On exhaustive search of available literature on pubmed, we found approximately 29 cases of lipoma of palate reported since 1919 till date,,,,,,,. The etiopathogenesis of lipoma is not completely understood. Heredity, hormones, trauma and infections have been implicated as possible causes. They commonly present as asymptomatic slow growing masses in the oral cavity. Symptoms are evident, when the tumor is large enough to interfere with mastication, swallowing or speech, similar to our case, causing difficulty in swallowing, respiration and phonation. They usually appear as well defined, smooth, lobulated, soft, cystic, non tender lesions with a characteristic yellowish color and sometimes prominent overlying superficial vessels. Mostly submucosal, the overlying mucosa may be stretched and thinned out. It can be differentiated from a fibroma, which has very similar presentation by the more firm nature of the latter. The other differential diagnosis includes tumours like granular cell tumour, liposarcoma, neurofibroma, mixed tumours, traumatic fibroma and mucocele.
On computed tomography, they demonstrate low attenuation with mass effect. On histopathological examination, the gross appearance is a bright yellow smooth mass with thin fibrous capsule. Microscopically, they show mature white adipose tissue without atypia. They differ from normal adipose tissue by increased cell size and they have relatively uniform cytoplasmic vacuoles. Surgical excision is the treatment of choice. In cases of well encapsulated masses, recur-rence is rare with conservative excision.
| Conclusion|| |
Lipomas are benign slow growing masses seen in oral and maxillofacial region, particularly parotid region, followed closely by the buccal mucosa. Their occurrence in palate is extremely rare due to lack of adipose tissue here. Therefore, it should be kept as a differential diagnosis when dealing with tumors of this anatomical site.
| References|| |
Bakshi SS, Priya M, Coumare VN, Vijayasundaram S, Karanam L. A common tumor in an uncommon lo-cation: Lipoma of the palate. Ann Maxillofac Surg. 5(2): 237-239.
Agrawal R, Chauhan A, Kumar P. Spectrum of Oral Lesions in ATer-tiary Care Hospital. “J Clin Diagn Res. 9(6): EC11-EC13.
de Visscher JG. Lipomas and fibroli-pomas of the oral cavity. J Maxillo-fac Su rg. 1982 Aug;10(3):177-81.
Wustrow F. Unusually large pendu-lous lipoma of the palate.Dtsch Zahnarztl Z. 1951 Apr l;6(7):386-8.
Tilley H. Large Submucous Lipoma of Palate and Pharynx. Proc R Soc Med. 1919;12(Laryngol Sect):189-193.
Decroix G, Libersa C. Two cases of dermoid tumors of the palate; pedi-cled lipoma and fibroma. Acta Oto- rhinolaryngol Belg. 1952;6(1):86-91.
Gridly Ms. Lipoma in the palate. J Egypt Med Assoc. 1954;37(8):983-5.
Cran Ja. Lipoma of the palate. Re-port of a case.Oral Surg Oral Med Oral Pathol. 1963 Apr;16:452-3.
Berti Ρ, Degaetani G. Rare Oncolog-ic Pathology Of The Oral Cavity (Li-poma, Sarcoma And Malignant Mel-anoma Of The Palate; Myxomaand Reticulosarcoma Of The Tongue). Arch De Vecchi Anat Patol. 1964 Oct;44:205-33.
Bertelli Ade P. Rare tumors of the palate (lipoma and schwannoma). Report of 2 cases. Rev Bras Cir. 1965 Jun;49(6):353-5.
[Figure 1], [Figure 2], [Figure 3]