Symmetric lipomatosis of the tongue （SLT） is a rare condition related to generalized lipidosis, often caused by chronic alcoholism. It is characterized by multiple lipomatous nodules symmetrically located within the tongue. We report a case of SLT arising in a 62-year-old man with a long history of alcoholic liver cirrhosis. He had multiple soft nodular protrusions on the left margin of the tongue for months, caused by involuntary self-inflicted tongue bites. Although computed tomography showed fatty masses on both sides of the tongue, no elevated tumor mass existed on the right margin. To prevent further tongue biting, the nodules were surgically removed. Histopathologically, the nodules consisted of mature adipose tissue lobules, which were clearly demarcated from the surrounding muscle tissue. Because of the patient’s lipidosis and unusual presentation of multiple lesions, the lesion was finally diagnosed to be SLT. A literature review showed 27 documented cases of SLT, mostly in Asian elderly men, and 73 ％ of all cases were associated with liver failure. SLT can be regarded as reactive hyperplasia of adipocytes in granulation tissue as a response to traumatic stimuli rather than neoplasia. Surgical intervention may be considered when the tongue lesions are traumatic and when perioperative management is indicated.
