原文題目(出處): Sialolipoma of the lower lip: Case report and literature review. The Open Dent J 2012;6:208-11.
原文作者姓名: Nada O. Binmadi,Risa Chaisuparat,Bernard A. Levy, Nikolaos G Nikitakis
通訊作者學校: Department of Oral Pathology and Medicine, Dental School, National and Kapodistrian University of Athens
報告者姓名(組別): Intern F 組 鄭宜文
報告日期: 2013/2/5
內文:
I.
AbstractSialolipoma is a relatively rare and fairly recently described as a variant of lipoma with salivary elements. Any site within the oral and maxillofacial region may be involved with the parotid gland being the most common location. Herein, we present a case of silaolipoma in lower lip. The clinical and histological features and differential diagnosis are discussed.
II.
Introduction- Sialolipoma1. A new histological variant of salivary gland lipoma 2. Composed of adipose and glandular tissues
3. The etiology of sialolipoma is not completely understood
4. Typically arises within the major salivary glands and the minor salivary gland of oral cavity.
III.
Case report1. General data:A 54-year-old Caucasian female
2. Chief complaint:A painless swelling in her lower left lip
3. Past medical history & family history:Unremarkable and no history of trauma or infection
4. Alcohol、Cigarettes:unremarkable
5. Intra-oral examination:A 0.6x0.6cm soft tissue mass with normal overlying mucosa in her left lower lip
6. Extra-oral examination:Revealed a normal facial morphology
7. Clinical differential diagnosis:Mucocele, fibroma, lipoma,and salivary gland neoplasm.
8. Histological examination : A mass of mature adipose tissue completely encapsulated by a fibrous band. Islands of salivary gland acini and ducts were located within the tumor. Neither atypia nor mitotic figures were observed in either the salivary glandular type tissue or the adipocytes. Mild lymphocytic infiltration and ductal dilation
9. Histologic Diagnosis: Sialolipoma
10. Treatment:An excisional biopsy was performed and no further treatment was required
11. 3-year follow-up:No recurrence was observed
IV.
Discussion- 35 cases of sialolipoma reported in English literature1. Sialolipoma is an uncommon variant of head and neck lipoma, is composed of proliferative adipocytes with entrapped normal salivary gland island
2. Almost any site within the oral and maxillofacial region may be involved with
the parotid gland being the most frequently reported location口腔病理科 On-Line KMU Student Bulletin
3. Eighteen of them were found in minor salivary glands (seven on the palate, three in buccal mucosa, three on floor of the mouth, two on the tongue , two in lower lip) in the former 34 cases
4. Sialolipomas usually present as a solitary painless palpable mass with an average size of 2.74 cm in diameter
5. Females are affected slightly more than males (with ratio1.7:2)
6. Patient’s ages range from 6 weeks to 84 years, with average of 47.6 years 7. The duration of the lesion range from two months to ten years, with average
of three years
8. There is no distinguishable radiographic sign for sialolipoma in either
computed tomography scan (CT) or magnetic resonance imaging (MRI) compared to a typical fatty lesion in the head and neck region
9. Histological findings of haematoxylin and eosin staining in previous studies include a well circumscribed mass surrounded by a delicate fibrous tissue 10. The tumors are composed of mature adipose elements mixed with salivary
gland tissues
11. The 80 % of sialolipomas in major salivary gland are composed of adipose tissue while in minor salivary gland the glandular elements are clustered and evenly distributed around fat tissue
12. The glandular components may be showed ductal dilation, oncocytic changes and squamous ductal metaplasia, lymphocyte infiltration and enlarged congested vessels are reported
13.
Adenolipoma has histologic characteristic similar to sialolipoma; but it is
composed of adipocytes and duct elements without acinar cells.Adenolipoma also differs from
sialolipoma by the lack of organoid arrangement of the ductal type tissue 14.
Lipomatosis which typically occurs in older patients can be excluded by the
microscopic lack of the fibrous capsule in addition to the absence of any medical condition associated with lipomatosis, for instance diabetes mellitus, malnutrition, chronic alcoholism and liver cirrhosis
15. The distinction from pleomorphic adenoma is made by the presence of extensive fatty elements within the normal salivary gland tissue and lack of ducts and strands of dark-staining myoepithelial cells in sialolipoma
16. Sialolipoma in the minor salivary glands is treated by complete surgical excision. Most of tumors in parotid glands are treated with superficial parotidectomy. A complete parotidectomy with preservation of the facial nerve has been reported in two cases
Fig. (1). (A) Photomicrograph showing islands of salivary gland tissue present within an adipose tissue tumor encapsulated by thin fibrous
tissue (arrow) (hematoxylin and eosin, original magnification 4x); (B) Higher magnification revealing mild ductal dilatation with fibrosis
within the tumor mass (hematoxylin and eosin, original magnification 10x).
口腔病理科 On-Line KMU Student Bulletin
題號 題目
1 Which one of lipoma is false?
(A) The lesion is nontender, and cheesy in consistency (B) Buccal mucosa is the most common site of the lesion (C) Tooth involvement is usually seen in premolar
(D) Lipoma is mature and fat tissue may be enclosed within a capsule 答案(C) 出處:Differential and diagnosis of oral and maxillofacial lesions,5th
edition
題號 題目
2 Which one is the most common place of oral lipoma?
(A) Buccal mucosa
(B) Lip
(C) Soft palate
(D) Tongue
答案(A) 出處:Oral and maxillofacial pathology,3rd edition