Spindle cell lipoma of the tongue: A case report of unusual occurrence
A 64-year-old Caucasian female patient sought dental care due to injury in a swelling on the left lateral border of the tongue. The patient noticed a swelling about 3 years back which was progressively increasing in size and presented as an enlarged tongue. At present, the patient reports difficulty in speech and swallowing. Her medical history revealed type 2 diabetes mellitus (T2DM) and hypertension for almost a decade. She was taking medication such as metformin, gliclazide, and beta blockers for her systemic pathologies. She has no history of smoking or alcohol usage. Clinical intraoral examination revealed the patient to be a removable denture wearer with good oral hygiene status. A characteristic nodular lesion which was elastic in consistency was noticed on the left lateral border on the anterior two-thirds of the tongue [].\nAn ultrasonography of the lesion was requested which showed a solid area about 20 × 20 × 13 mm in its largest diameter, located in the left lateral border of the tongue. It showed regular, well-defined margins with homogeneous texture. A Doppler study showed some peripheral vessels associated with the lesion [].\nThe patient was referred to her physician for pre-operative routine examination following which, the patient underwent excisional biopsy under local anesthesia. The lesion was removed after dilatation and dissection of the surrounding tissues [].\nAfter irrigation, the surgical wound was sutured with 4.0 vicryl suture material. The patient received appropriate postoperative care and was discharged. The specimen was sent for pathological examination. Macroscopic examination revealed a nodular lesion measuring approximately 2.2 × 1.8 × 1.3 cm in its greatest dimension covered by a smooth, shiny, yellowish translucent capsule [].\nMicroscopic examination revealed expansive mesenchymal neoplasm composed of sheets of mature fat cells with typical fine vascular network, thick fibrous beams, and spindle cells permeating the sheets of fat cells. The subcapsular margins were free of tumor invasion. The features were consistent with a SCL [].\nThe post-operative follow-up demonstrated regression of the lesion with good tissue repair. No complaint in mastication and speech was noted.