Infiltrating lipomatosis of the face: A case series
A 17-year-old female reported with a complaint of swelling in the right cheek, present since birth. The patient first presented with the lesion in 2009. She underwent surgical excision from zygoma and mandible. The lesional tissue was sent for histopathologic examination which was suggestive of an infiltrating lipomatous lesion. In late 2010, the swelling recurred and an incisional biopsy was performed, suggestive of infiltrating lipomatosis. The patient was unwilling to undergo any further treatment. She reported again in 2012 with an increase in the size of the previously reported swelling.\nOn extraoral examination, a swelling was present unilaterally over the right maxilla/zygoma, extending upward till orbit, posteriorly till the ear lobe, and inferiorly to the lower border of the mandible []. The swelling was soft on palpation; no lymph nodes were clinically palpable. Intraorally, there was enlargement of the maxillary right posterior alveolar region, extending from the maxillary right second premolar posteriorly up to the tuberosity.\nOn contrast-enhanced computed tomography (CECT), the right masseter and buccinator appeared heterogeneous with areas of fat attenuation within. There was an increase in the right side buccal fat with extraoral fat stranding which caused poor differentiation of lateral margins of underlying muscles []. Right parotid and submandibular gland also appeared mildly bulky and heterogeneous with areas of fat attenuation within, likely due to fatty infiltration. Right side facial bones appeared mildly thickened. An incisional biopsy was done, which on microscopic examination showed fat cells infiltrating in the muscle and admixed with blood vessels in a loosely collagenous stroma []. It was suggestive of infiltrating lipomatous lesion. The patient underwent surgical excision and the excised tissue submitted to the department was in the form of multiple soft tissue bits, yellowish in color, the largest measuring 3 × 2.5 × 2 cm []. The excisional tissue studied was compatible with infiltrating lipomatosis.