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      Oral Fibrolipoma-A Rare Histological Entity: Report of 3 Cases and Review of Literature

      case-report

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          Abstract

          Lipomas are rare benign soft tissue mesenchymal neoplasms in the oral cavity, representing 1% of all benign oral tumors. Fibrolipoma (FL), an uncommon, histological variant of the classic lipoma, mostly affects the buccal mucosa. Very few cases of FL have been reported in the English literature. To the best of our knowledge a review of the English literature showed 33 cases of FL affecting the oral cavity.

          The diagnosis and differentiation of FL with clinically similar lesions such as fibroma, mucocele and pleomorphic adenoma are very essential for a correct treatment plan and complete follow-up. Due to the rarity of oral cavity fibrolipoma reports, three cases and a review of literature is presented here.

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          Most cited references29

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          Lipomas of the oral cavity: clinical findings, histological classification and proliferative activity of 46 cases.

          Lipomas represent about 1 to 5% of all neoplasms of the oral cavity. Although relatively common, few large series of intraoral lipomas and its variants are seen in the literature. Therefore, the authors present the clinical, histological and immunohistochemical features of 46 cases of intraoral lipomas reviewed from the files of the University of Campinas Dental School from 1970 to 2001. Most of the cases affected adults, without gender predilection, and the main involved sites were the buccal mucosa (21 cases), tongue (six cases), lips (six cases) and floor of mouth (five cases). The histological analysis revealed 21 cases of lipoma, 18 fibrolipomas, four intramuscular lipomas, two minor salivary gland lipomas and one spindle cell lipoma. PCNA and ki-67 expression indexes were higher in spindle cell lipoma, intramuscular lipomas and fibrolipomas compared to common lipomas, but the differences were not statistically significant. All lesions were removed surgically and none showed recurrence, regardless of the various proliferative activities.
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            Lipoma of the oral and maxillofacial region: Site and subclassification of 125 cases.

            Lipomas and lipoma variants are common soft tissue tumors, but occur infrequently in the oral and maxillofacial region. In this study, we reviewed 125 lipomas in specific oral and maxillofacial locations. We wanted to examine and compare the clinicopathologic features of these tumors. Study design The records from the Oral and Maxillofacial Pathology Registry of the Armed Forces Institute of Pathology from 1970 to the present were searched for cases coded as "lipoma." This study included 125 cases based on location within the oral and maxillofacial region, benign histology, and available clinical information. Subcutaneous and intraosseous lipomas were excluded. The tumors were classified according to the most recent World Heath Organization classification for soft tissue tumors. Of 125 lipomas, 91 tumors occurred in males, 33 in female patients, and 1 of unknown gender. The mean age was 51.9 years, range 9-92 years. Four tumors occurred in pediatric patients (age <18 years). Specific anatomic sites within the oral and maxillofacial region included the parotid region (n=30); buccal mucosa (n=29); lip (n=21); submandibular region (n=17); tongue (n=15); palate (n=6); floor of mouth (n=5); and vestibule (n=2). The mean size of tumors was 2.2 centimeters, range 0.5 to 8.0 centimeters. The mean duration of the tumors prior to excision was 3.2 years, range 6 weeks to 15 years. Most patients presented with an asymptomatic, circumscribed mass. Grossly, most tumors were described as pink and smooth, occasionally mucoid. Histologically, the tumors were subclassified as classic lipomas (n=62); spindle cell/pleomorphic lipomas (n=59); fibrolipoma (n=2), and chondroid lipoma (n=2). Fourteen tumors exhibited secondary changes, such as fat necrosis, atrophy, and prominent hyalinization; 23 tumors were histologically confirmed to be intramuscular. Lipomas of the oral and maxillofacial region occur most commonly in adult males in the parotid region, followed closely by the buccal mucosa. These tumors are uncommon in children. Interestingly, spindle cell lipomas are common in this region and comprise the majority of our parotid and lip tumors. Angiolipomas were absent in this anatomic region in this study. Secondary changes and atrophy should not be confused with the malignant histologic features of a liposarcoma.
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              Diagnostic Surgical Pathology of the Head and Neck

              DR Gnepp (2001)
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                Author and article information

                Journal
                J Dent (Tehran)
                JDT
                Journal of Dentistry (Tehran, Iran)
                Tehran University of Medical Sciences
                1735-2150
                2008-2185
                2010
                30 September 2010
                Autumn 2010
                : 7
                : 4
                : 226-231
                Affiliations
                [1 ]Associate Professor, Deptment of Oral Pathology and Microbiology, Sumandeep Vidyapeeth, K M Shah Dental College and Hospital, Pipariya,Vadodara, Gujarat State, India
                [2 ]Senior lecturer, Department of Oral Pathology and Microbiology, Sumandeep Vidyapeeth, K M Shah Dental College and Hospital, Pipariya,Vadodara, Gujarat State, India
                [3 ]Professor, Department of Oral Pathology and Microbiology, Sumandeep Vidyapeeth, K M Shah Dental College and Hospital, Pipariya,Vadodara, Gujarat State, India
                Author notes
                Corresponding author: B.S. Manjunatha, Associate Professor, Dept of Oral Pathology, KM Shah Dental College Sumandeep Vidyapeeth Pipariya--391760 Waghodia Vadodara, Gujarat, India. drmanju26@ 123456hotmail.com
                Article
                jod-7-226
                3184759
                21998799
                38333b64-048c-4bd5-903d-3a98b7b98203
                Copyright © Dental Research Center, Tehran University of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                : 15 April 2010
                : 20 October 2010
                Categories
                Case Report

                Dentistry
                lipoma,adipose tissue neoplasms,buccal mucosa,adipocytes
                Dentistry
                lipoma, adipose tissue neoplasms, buccal mucosa, adipocytes

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