Abstract
Background:
Lipomas are soft tissue tumors found mostly in adults between the fifth and seventh decades, and their exact cause remains unknown. Oral lipomas are rare compared to other body locations and are most often found in the buccal mucosa and buccal vestibule.
Case presentation:
We present a case of a non-tender oral lipoma in a 52-year-old female with a painless, soft, slowly evolving swelling causing facial asymmetry. We carried out, under local anesthesia, an intra-oral lipomectomy, and the histopathology confirmed the diagnosis of a lipoma. Postoperative control showed a dissipation of the facial asymmetry as well as good healing.
Conclusion:
Our case report demonstrates this complete process, from diagnosis to postoperative control, showing the importance of an intra-oral approach to improve outcomes and esthetics.
Keywords: facial asymmetry, good evolution, intra-oral surgery, oral lipoma
Introduction
Lipomas are benign soft tissue tumors made of mature adipocytes that are mostly found in adults and are the most common benign mesenchymal tumors[1,2] with a reported prevalence of 2.1 per 1000 people[3]. The exact etiology remains a mystery.
The majority of lipomas affect the trunk and upper extremities, but they can occur anywhere on the body where adipocytes are present[4]. With respect to oral lipomas, they are relatively rare compared to other body sites, with a reported frequency of 1–4%[5], and the most affected oral cavity sites are the buccal mucosa and buccal vestibule, representing close to 50% of oral lipomas[6].
Case presentation
A 52-year-old female came to the Odontostomatology service of the YUTH, presenting with a complaint of a non-tender labial swelling that has been evolving for about a year now, discovered fortuitously by a physician during a tooth avulsion. The swelling has progressively increased in volume. There is no history of drug use or any other relevant past medical history.
HIGHLIGHTS
Lipomas are the most common mesenchymal tumors.
Lipomas are of unknown etiology and are mainly located in the trunk and upper extremities.
Oral lipomas are relatively rare and can cause both esthetic and functional problems.
We carried out, under local anesthesia, an intra-oral lipomectomy, and the postoperative control showed a dissipation of the facial asymmetry, which was the principal complaint of the patient.
We present a case of an oral lipoma, from initial diagnosis to postoperative control, using an intra-oral surgical approach with good healing and absence of initial facial asymmetry.
Extra-orally, the patient presented with facial asymmetry due to a right facial swelling with a soft texture, mobile, and non-tender on palpation. The extra-oral limits were: the lower lip vermilion superiorly, the right labial commissure laterally, the labiomental fold inferiorly, and the middle labial third mesially.
Our provisional diagnosis was an oral lipoma.
An intraoral lipomectomy was carried out under local anesthesia as per the treatment plan, and the surgical sample was sent for histopathology.
The histopathology confirmed the diagnosis of a lipoma. We carried out a postoperative follow-up 2 months later, which showed good scarring and the absence of facial asymmetry.
In total, from diagnosis to good healing, it took 63 and 56 days from surgery to scarring. The temporal procedure and evolution can be better appreciated, as seen in Figures 1–3.
To better appreciate the facial esthetic differences and the reduction of facial asymmetry, we place side by side the pre- and post-frontal views, showing the importance and necessity of surgery (Fig. 3).
Figure 3.
Comparative pre- and postoperative frontal view of the patient, showing a reduction in facial asymmetry.
Discussion
We present a case report of an oral lipoma, from diagnosis to healing, highlighting the significant esthetic outcome in an esthetic region, which is the face.
Lipomas typically appear as soft, movable, non-tender subcutaneous swellings. Lobulated sensation, slipping sign, and pseudo-fluctuation are some clinical diagnostic indicators[7]. In terms of size, the majority of lipomas are reported to present at less than 3 cm[8]; however, they could be present at sizes between 5 and 11 cm[9]. Additionally, our patient’s age of 52 falls within the reported usual age range of 40–60 years.
The occurrence of oral lipomas could be associated with the amount of available adipose tissue. In the case of oral lipomas, the buccal mucosa has a higher incidence, and this could be due to its proximity to the buccal fat pad, which is rich in adipose tissue[1].
Regarding therapeutics, the intra-oral approach is preferable as it renders a good outcome and better esthetics[10]. In addition, a complete lipoma resection should be effectuated, as it is key to preventing recurrence[10].
Oral lipomas, when of sufficient size, can create a mass effect on the face, leading to a poor esthetic look (Fig. 1I–III), and as we have shown in our case (Fig. 3), an intra-oral approach reduces the facial asymmetry and enhances the esthetic appearance.
Figure 2.
Postoperative view. (a) Postoperative control 2 months later: Note the absence of facial asymmetry. (b) Postoperative control: Intra-oral view showing good healing.
Figure 1.
I: Preoperative view showing facial asymmetry due to right lower facial swelling. (A) Frontal preoperative view. (B): Lateral preoperative view. (C): ¾ facial view or 45° preoperative angle view. IIa: Intra-oral view. (D): Intra-oral view without pressure on the lesion. (E): Intra-oral view with pressure on the lesion, displaying typical yellow color. IIb: Per-operative view. (F) (G): Intra-oral per-operative view with typical yellow color. (G): Per-operative view showing the pedunculated base of the lipoma. III (H): Macroscopic appearance of the lesion following complete resection. (I): Histopathology view showing mature adipocytes separated by dense connective tissue.
Our study was carried out in accordance with the SCARE criteria[11].
Conclusion
Oral lipomas are uncommon and can cause facial esthetic concerns when they reach a certain size. An intra-oral surgical approach helps to improve the esthetic appearance and outcome, resulting in patient satisfaction. Our case report demonstrates this complete process, from diagnosis to postoperative control.
Acknowledgements
Not applicable.
Footnotes
Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.
Ethical approval
We received ethical approval for our study.
Consent
We received voluntary, informed consent.
Sources of funding
None.
Author contributions
Conception and design of the study: Z.B.N., T.F.S., K.T.A., N.K.S., N.N.D.B. Acquisition of data: Z.B.N., K.T.A., N.K.S., N.N.D.B. Analysis and interpretation of data collected: Z.B.N., T.F.S., K.T.A., N.N.D.B. Drafting of the article and/or critical revision: Z.B.N., T.F.S., K.T.A., N.K.S., N.N.D.B. Final approval and guarantor of the manuscript: Z.B.N.
Conflicts of interest disclosure
The authors declare having no conflicts of interest.
Research registration unique identifying number (UIN)
Not applicable.
Guarantor
Not applicable.
Provenance and peer review
Not applicable.
Data availability statement
Not applicable.
References
- [1].Dehghani N, Razmara F, Padeganeh T, et al. Oral lipoma: case report and review of literature. Clin Case Rep 2019;7:809–15. [DOI] [PMC free article] [PubMed] [Google Scholar]
- [2].Kanojia D, Dakle P, Mayakonda A, et al. Identification of somatic alterations in lipoma using whole exome sequencing. Sci Rep 2019;9:14370. [DOI] [PMC free article] [PubMed] [Google Scholar]
- [3].Silistreli ÖK, Durmuş EÜ, Ulusal BG, et al. What should be the treatment modality in giant cutaneous lipomas? Review of the literature and report of 4 cases. Br J Plast Surg 2005;58:394–98. [DOI] [PubMed] [Google Scholar]
- [4].Kolb L, Yarrarapu SNS, Ameer MA, et al. Lipoma. 2025.
- [5].Mehendirratta M, Jain K, Kumra M, et al. Lipoma of mandibular buccal vestibule: a case with histopathological literature review. BMJ Case Rep 2016;2016:bcr2016215586. [DOI] [PMC free article] [PubMed] [Google Scholar]
- [6].Fregnani ER, Pires FR, Falzoni R, et al. Lipomas of the oral cavity: clinical findings, histological classification and proliferative activity of 46 cases. Int J Oral Maxillofac Surg 2003;32:49–53. [DOI] [PubMed] [Google Scholar]
- [7].Vagholkar K, Vagholkar S, Purandare T. Lipoma: neoplasm beyond boundaries. Inter Surg J 2024;11:1954–57. [Google Scholar]
- [8].Egido-moreno S, Lozano-porras A, Mishra S, et al. Intraoral lipomas: review of literature and report of two clinical cases. J Clin Exp Dent 2016. doi: 10.4317/jced.52926 [DOI] [PMC free article] [PubMed] [Google Scholar]
- [9].Ntep Ntep DB, Bengondo C, Kenna E, et al. A giant oral lipoma with possible post-traumatic origin: a rare entity at the University Teaching Hospital Center of Yaounde. Oral Health Dent Manag 2019;18. doi: 10.35248/2247-2452.19.18.1061 [DOI] [Google Scholar]
- [10].Muath Mamdouh Mahmod A-C, Wan Azman Wan S. Intra-oral approach of giant cheek lipoma excision guaranteed aesthetic outcome: a case report. Int J Oral Dent Health 2020;6. doi: 10.23937/2469-5734/1510113 [DOI] [Google Scholar]
- [11].Kerwan A, Al-jabir A, Mathew G, et al. Revised Surgical CAse REport (SCARE) guideline: an update for the age of Artificial Intelligence. Prem J Sci 2025;10:100079. [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
Not applicable.