Symmetric lipomatosis of the tongue presenting as macroglossia: A case report

Abstract

Symmetric lipomatosis of the tongue (SLT) is defined as an infiltrative growth of mature adipose tissues into bilateral tongue muscle. Here, we report a case of SLT presenting as macroglossia and review the literature. The patient was a 71-year-old man who had multiple painless elastic soft masses in the bilateral tongue borders. The patient's tongue was wider than the mandibular dental arch due to the exophytic masses of the tongue, so-called macroglossia. Magnetic resonance imaging revealed poorly marginated masses of the bilateral tongue borders with low signal intensity in T2 fat suppression images and high in both T1 and T2 weighted images. The biopsy specimen was diagnosed as lipoma. Because the tumor masses were located in the bilateral border of the tongue, the patient was diagnosed as SLT.
As he had taken anti-coagulant agents for chronic atrial fibrillation, airway obstruction by postoperative bleeding and edema was feared. The debulking operation of the masses was performed twice under general anesthesia. The extirpated specimens showed lesions consisting of mature adipose tissues in muscular layer. No apparent capsule structure was noted.
Between 1947 and 2015, 45 cases of benign symmetric lipomatosis, symmetric lipomatosis of the tongue, bilateral lipomatosis of the tongue, and so on were reported. The pathogenesis of SLT is still unknown. No regrowth has been found in the last two years.