The importance of early diagnosis of large lipomas in the maxillofacial region

Lipomas are benign tumors of mesenchymal origin consisting of mature fat cells which usually are involved by a thin fibrous capsule. There are several forms and dimensions in this pathology depending of location, evolution time which may cause orofacial deformity in some patients. Lipoma's etiology remains uncertain, even after pointing endocrine changes and heritance factors as possible causes. It is known that lipomas are mainly present I n the fifth and sixth decade of life, being rarely found during childhood. Some authors reported that there is major incidence in males, not having any ethnical relation. Lipomas represent the most common tumor of soft tissues being between 15 and 20 % in oral cavity. Many studies have reported the buccal mucosa as the site with major occurrence of these lesions, but it has also been seen in lips, tongue, palate, buccal vestibule, floor of the mouth and parotid region. Clinically, lipoma is a superficial lesion having slow growth, generally asymptomatic, well defined, sessile or pedunculated base, lobule or unique mass, and yellow coloration.

Some imaging examinations may be used to complement the diagnosis, being necessary to do an incisional or excisional biopsy to confirm the diagnosis and by histopathology. In order to do a clinic diagnosis, yellow coloration of lipomas should be observed as well as an event of fluctuation of the lesion when it is soaked in a recipient with formol 10 %, this lesion will be on the liquid surface due to its lower density than a fixer solution.