A case of tumor of the tongue that was considered a morphologically atypical lipomatous tumor

Abstract

Atypical lipomatous tumor (ALT) is a relatively common soft tissue tumor, but it is extremely rare in the head and neck region, especially in the oral cavity. We report a case of tumor of the tongue that was considered a morphologically atypical lipomatous tumor. A 65-year-old woman was referred to our hospital with a mass on the right side of her tongue. Clinical examination revealed a well-demarcated, movable, elastic-hard, and painless lesion, with a diameter of 15 × 15 mm. We made a provisional diagnosis of a benign tumor and performed an incisional biopsy. The pathological diagnosis was ambiguous, ranging from lipoma to ALT. An excisional biopsy was performed with the patient under local anesthesia with intravenous sedation. Microscopic examination revealed a well-circumscribed lesion, composed of proliferative fat cells with considerable variations in size and shape, as well as many multi-vacuolated lipoblasts. The final histopathological diagnosis was morphologically ALT. We surgically excised an additional 10 mm of the tissue surrounding the tumor with the patient under general anesthesia. The patient has remained free of recurrence and metastasis for 5 years after surgery.