Liposarcomas/atypical lipomatous tumors of the oral cavity: a clinicopathologic study of 23 cases.

Liposarcomas in the oral cavity have rarely been described, with less than 50 reported cases to date and a purported predominance of the myxoid type. We reviewed our experience with 23 atypical lipomatous tumors/liposarcomas of the oral cavity. Twelve patients were men, 10 were women, and gender was not stated in one case. Age at presentation ranged from 28 to 83 years (median, 49.5 years). The most commonly affected site was the tongue and most cases presented as a slowly growing, painless mass. The clinical impression was lipoma or fibroma in the majority of cases. Tumor size ranged from 0.6 to 8.0 cm (median, 1.5 cm). Five cases were well circumscribed, 5 cases were focally infiltrative, and 13 cases had markedly infiltrative margins. Twenty-one cases were classified as atypical lipomatous tumors (of which 10 showed spindle cell features), one as dedifferentiated liposarcoma, and one as myxoid liposarcoma. Follow-up data was available in 13 of the 23 cases. Five others were lost to follow-up after a short period. Eleven patients remained free of disease without local recurrence or metastasis during the period of follow-up that ranged from 10 months to 9 years (median, 24 months). Two patients had multiple local recurrences. Our study shows that atypical lipomatous tumor is the most common type of malignant fatty tumor to arise in the oral cavity with an apparently low risk of recurrence if widely excised, although follow-up is relatively limited thus far.