Abstract

Introduction: Lipomas are common benign mesenchymal neoplasms composed of mature adipocytes, but their occurrence in the oral cavity is rare, accounting for only 1–4.4% of benign intraoral tumors. Among these, lipomas arising in the floor of the mouth are particularly uncommon (4–11%). Due to the complex anatomy of the sublingual region, diagnosis and management require careful clinical, radiological, and histopathological correlation.

Case report: A 52-year-old male presented with a painless, progressively enlarging sublingual swelling for two months, associated with difficulty in speech. Clinical examination revealed a soft, non-tender, 4×5 cm swelling on the floor of the mouth with negative transillumation.

MRI showed a well-circumscribed lesion with classic imaging characteristics of lipoma T1/T2 hyperintensity and fat-suppression hypointensity measuring 52×32×39 mm, displacing adjacent tongue musculature. Complete surgical excision was performed under general anesthesia via a midline approach. The excised mass measured 4.8×4×3.8 cm.

Conclusion: Sublingual lipomas are rare lesions that may mimic other developmental or neoplastic masses of the floor of the mouth. MRI serves as a valuable modality for assessing lesion extent, while definitive diagnosis requires histopathological confirmation. Surgical excision remains the treatment of choice, with excellent prognosis and low recurrence rates when completely removed.

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