Spindle Cell Lipoma on the Floor of the Mouth

Case Presentation

J Dent App.2015; 2(8): 291-294.

Spindle Cell Lipoma on the Floor of the Mouth

Yalçin M¹, Atilgan SS¹, Laçin N¹, Atalay Y²*

¹Department of Oral and Maxillofacial Surgery, Dicle University, Turkey

²Department of Oral and Maxillofacial Surgery, Afyon Kocatepe University, Turkey

*Corresponding author: Atalay Y, Department of Oral and Maxillofacial Surgery, Afyon Kocatepe University, Faculty of Dentistry, Turkey

Received: March 05, 2015; Accepted: September 10, 2015; Published: September 12, 2015


Spindle Cell Lipoma (SCL) is a benign lipomatous histological variant of lipoma which is rarely observed in the oral cavity. It presents as a circumscribed mass in the buccal mucosa, tongue, floor of the mouth or hard palate. In English literature there are nearly 10 case reports of SCL on the mouth floor, all of which were treated with local excision. A case is here presented of intraoral spindle cell lipoma on the floor of the mouth of a 49-year old female. Although oral SCL is rare, it should be considered in the differential diagnosis of lipamatous neoplasms occurring on the mouth floor.

Keywords: Lipoma; Spindle cell lipoma; Oral cavity; Mouth floor


Lipomas rarely occur in the oral and maxillofacial region. One kind is the Spindle Cell Lipoma (SCL), which is typically seen as a benign lipomatous neoplasm in the posterior neck and back of older males, and accounts for approximately 1.5% of all lipoma cases [1]. In the oral cavity, the buccal mucosa, tongue, and floor of the mouth are common locations of lipomas [2]. They present as a slow-growing, painless, asymptomatic yellowish, nodular, sub mucosal mass and are covered by normal mucosa. Oral lipomas may cause mastication and speech difficulties [3]. SCL is a distinct histological variant of lipoma derived from prelipoblastic mesenchymal cells [4]. SCL is a rare benign neoplasm, and oral SCL is extremely rare. In this paper, a case is reported of SCL localized to the floor of the mouth in a 49-year old female, and the clinical, histopathological and immune histochemical findings of this case are presented.

Case Presentation

A 49-year old female patient was referred to the Department of Oral and Maxillofacial Surgery with the complaint of swelling on the floor of the mouth, which had been ongoing for 2 years (Figure 1). The patient complained of occasional discomfort while speaking. The growth was gradual in onset, and had slowly increased in size over a period of 2 years to reach its present size. The well circumscribed swelling was not tender on palpation, soft in consistency and mobile. In the intraoral examination, a smooth well-defined sessile nodule of similar color to the surrounding mucosa was detected on the anterior floor of the mouth (Figure 1). It was superficially located and non-infiltrating in front of the sublingual caruncle (opening of the submandibular and sublingual duct) on the floor of the mouth (Figure 1). Based on the history and clinical findings, a provisional diagnosis of lipoma was considered. Excisional biopsy was made under local anesthesia. The yellowish, well-circumscribed soft tissue mass with a lobulated surface 1.5 x 1 x0.5 cm (length x width x thickness) in size was totally excised and sent for microscopic examination in 10% buffered formalin (Figure 2,3,4). In the microscopic examination of H and E stained slides, using a light microscope, a well-circumscribed nodular mass was seen. The histopathology of the soft tissue section showed an encapsulated lesion composed of abundant mature adipocytes arranged in lobules, infrequent blood capillaries, collagen-forming CD34-positive spindle cells and wiry collagen in a variable myxoid background. The lobules were separated by fibrous connective tissue septa. The adipocytes appeared polygonal in shape with clear cytoplasm and the placement of a peripheral flat nucleus that was compressed against the cell membrane (Figure 5A, 5B). Based on clinical and histopathological findings, the swelling was finally diagnosed as SCL. No recurrence has been detected since surgery (Figure 6).