Diagnosis and treatment of lipoma in the oral and maxillofacial region. Case report

Abstract

Introduction. Lipomatous soft-tissue tumours are frequently seen neoplasm, characterised as soft, painless, encapsulated masses. In the Oral and Maxillofacial region these tumours account for 1-4.4%. Of interest is the lack of complaints for this type of tumour which is favourable for the tumour's growth with delayed addressing the specialist. Common sites are: parotid region, submandibular, tongue. Diagnosing a lipoma doesn’t present difficulties because of classical clinical presentation, also the treatment is ordinary consisting in tumour excision. Case presentation. Patient AN, women, 42 years was diagnosed with solitary lipoma localised in the lateral cervical left region. The diagnosis was established after the clinical and paraclinical examination: ultrasonography, magnetic resonance imaging. The treatment performed was a typical excisional procedure consisting of future incision marking, after the incision the dissection of the tissues were performed and the tumour was exposed with the excision of lipoma. The closing was performed by layered suturing the tissues and a drain was placed. No complication was noted during the rehabilitation period. Discussion. Patients suffering from lipoma tumours localised in the oral and maxillofacial region present interest for the surgeons because of the complex morphofunctional and esthetic characteristics (complex vascularization and innervation, high esthetic demands from patients). The tumours are slow growing with predominantly superficial localization (subdermal), but cases of deep localization were also reported (intermuscular, subfascial). Another specificity is the tumour dimension, which varies from small (<3cm), medium (4-6cm) and big sized (7-10cm). Tumours don’t grow more than 10cm, but rare cases are reported of giant lipoma that are bigger than 10cm. The treatment tactics depend on the size and lipoma localization, in cases where it has a small size and superficial location the treatment is ordinary unless it has large proportions and deep location. Conclusion. Lipomatous tumours have an easy diagnosis and treatment with few adverse consequences for patients. Because the rate of growth is low the treatment can be postponed for a period of time, but it was demonstrated that morbidity is directly proportional with dimension and tumour depth.