Soft yellowish submucosal mass of the buccal mucosa
51-year-old female
§Chief complaint
Painless soft lump inside the cheek, slowly enlarging over 2 years
§Medical & dental history
- 01Well controlled hypothyroidism
- 02No other lipomas identified
- 03Occasional cheek biting over the lump
§Clinical examination
- 01Soft, mobile, non-tender submucosal mass 22 mm with a yellowish hue through thin mucosa
- 02Slip sign positive; no fixation to deeper structures
- 03No pulsation, no bruit, no blanching
- 04No lymphadenopathy
§ figuresFigures (4)
Fig. 1Lipoma removed from a 24 year old patient with Familial Multiple Lipomatosis.
“Lipoma removed from a 24 year old patient with Familial Multiple Lipomatosis” · JR3336 · CC BY-SA 4.0 · Wikimedia Commons
Fig. 2Lipoma
“Lipoma 02” · Sikander Iqbal · CC BY 3.0 · Wikimedia Commons
Fig. 3Lipomas removed from the arm of a patient with familial multiple lipomatosis
“Lipomas removed from the arm of a patient with familial multiple lipomatosis” · JR3336 · CC BY-SA 4.0 · Wikimedia Commons
Verified open-access images only, reproduced for education under their stated licences · no AI-generated or illustrative artwork · Oral Lipoma figures pending faculty review.
§Differential diagnosis
§Final diagnosis
Submucosal lipoma of the right buccal mucosa
A soft, mobile, yellow-tinged submucosal mass with a positive slip sign, confirmed by histology showing lobules of mature adipocytes with a thin fibrous capsule, is a simple lipoma.
§Investigations
- 01Clinical diagnosis with excisional biopsy
- 02Ultrasound or MRI only for large or deep lesions to define extent
§Radiology
- 01Ultrasound — well-defined homogeneous hyperechoic mass in the submucosa, no vascularity on Doppler
§Treatment plan
- 01Conservative surgical excision under local anaesthesia
- 02No further treatment needed after complete excision
§Surgical procedure
- 01Mucosal incision over the mass; well-encapsulated yellow lobulated lesion enucleated bluntly; closure with resorbable sutures, Stensen duct identified and avoided
§Histopathology report
Lobules of mature adipocytes of uniform size separated by thin fibrous septa, with a delicate capsule. No atypia, no lipoblasts. Lipoma.
§Follow-up & outcome
- 011 week — healed
- 026 months — no recurrence, mucosa normal
Outcome: Simple excision was curative with no recurrence.
§Discussion
- 01Oral lipomas are uncommon, representing 1-4% of benign oral lesions; buccal mucosa is the most frequent site.
- 02Recurrence after complete excision is rare; variants include fibrolipoma, spindle cell lipoma and angiolipoma.
- 03A rapidly growing, fixed or painful fatty lesion should raise the possibility of liposarcoma and needs imaging first.
§Clinical pearls / learning points
- 01The slip sign and yellow hue are the most useful bedside clues.
- 02Identify and protect the parotid duct when operating on the buccal mucosa.
§Viva questions
What is the slip sign?
The lesion slips away from the examining finger on gentle pressure, typical of a soft encapsulated fatty mass.
Name histological variants of lipoma.
Fibrolipoma, angiolipoma, spindle cell lipoma, pleomorphic lipoma, myxoid lipoma and intramuscular lipoma.
§MCQs
Q1The commonest intraoral site for a lipoma is:
Q2Histologically a lipoma consists of:
§ evidenceReferences & Evidence
Current Classification
WHO Classification of Head and Neck Tumours
5th Edition — Volume 9
WHO Classification of Tumours Editorial Board · 2022
The authoritative international classification of head and neck, odontogenic and salivary gland tumours. Current terminology on this site follows this edition.
Evidence summary
Highest level of evidence linked to this page: WHO / Official Classification.
- L1 · Classification — 2
- L6 · Textbook — 3
1 linked source was published from 2024 onwards. Where guidance is limited or contested, rely on the higher-level sources above rather than this summary. Educational use only — not a substitute for clinical judgement.
Content last reviewed
September 2026
Evidence last reviewed
September 2026
Next scheduled review
September 2027
Review status
EVIDENCE REVIEWED
Search latest PubMed evidence
Last literature search: 7 September 2026
Current Classification
WHO Classification of Tumours Editorial Board. IARC / World Health Organization · 2022
The authoritative international classification of head and neck, odontogenic and salivary gland tumours. Current terminology on this site follows this edition.
IARC / WHO. IARC · 2022
Continuously updated online edition of the WHO head and neck tumour classification.
Histopathology References
Barnes L. CRC Press · 2008
Detailed histopathological reference for head and neck diagnostic criteria.
Textbook References
Neville BW, Damm DD, Allen CM et al.. Elsevier · 2024
Standard reference textbook of oral and maxillofacial pathology used throughout this atlas.
Rajendran R, Sivapathasundharam B. Elsevier · 2020
Undergraduate and postgraduate oral pathology textbook widely used in BDS and FCPS curricula.
Additional sources cited on this page
- Neville BW et al. Oral and Maxillofacial Pathology, 4th edition.
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