Large Buccal Space Lipoma Excised Through an Intraoral Approach.

Lipomas are benign tumors of adipose tissue. They represent the most common mesenchymal neoplasm but are relatively rare in the oral and maxillofacial regions. The purpose of this study is to present an unusual case of a large lipoma of the buccal space and its excision by an intraoral approach. A 38-year-old male patient presented with an otherwise asymptomatic swelling of the right cheek that had first been noticed four years earlier and had subsequently exhibited gradual, continuous enlargement with stable dimensions over the last year. The patient was obese but otherwise healthy. Examination revealed a movable, well-circumscribed, non-fluctuant, soft-elastic large swelling of the right buccal and parotid-masseteric region with normal overlying skin and no bruit. Ultrasound and MRI findings, as well as fine needle aspiration, were suggestive of lipoma. The lesion was excised under general anesthesia through an intraoral approach. The tumor measured 7.0 cm × 5.3 cm × 1.6 cm and was separated from the surrounding tissues by a thin capsule. Histopathologic examination rendered a final diagnosis of lipoma. No signs of recurrence were noted. Although lipomas are the most common mesenchymal neoplasm, they do not usually occur in the oral and maxillofacial region, especially as large lesions are located in the buccal space, and may pose diagnostic and therapeutic challenges.