lipomas are the most common benign mesenchymal tumors developing in any location where fat is normally present .
the etiology of lipomas is uncertain and the tumors mainly affect the region of the trunk , shoulders , neck , and axilla .
involvement of the oral cavity is rare , with lipomas corresponding to less than 4.4% of all benign oral soft tissue tumors .
they commonly present as slow - growing asymptomatic lesions with a characteristic yellow color and soft , doughy feel in the buccal mucosa , floor of the mouth and tongue in the fourth and fifth decades , and generally with no gender predilection .
oral lipomas can occur in various anatomic sites including the major salivary glands , buccal mucosa , lip , tongue , palate , vestibule , and floor of mouth .
although benign in nature , their progressive growth may cause interference with speech and mastication due to tumor 's dimension .
a 10-year - old female patient reported with a chief complaint of swelling on left cheek .
the swelling was first noticed two years ago , which showed slow continuous gradual enlargement .
intraoral examination revealed a pinkish , well - defined oval swelling measuring 2.5  3 cm present in the left buccal mucosa [ figure 1 ] . on palpation , the swelling was soft , fluctuant , non - tender , mobile , and the margins were slippery under the palpating finger .
the lesion was excised under local anesthesia and the excised tissue was sent for histopathological examination [ figures 2 and 3 ] .
showing fibrolipoma of left buccal mucosa buccal mucosa after surgical resection of the lesion microscopic examination revealed adipose tissue with compressed blood vessels embedded within dense collagen fibers .
the overlying epithelium was 8 to 10 layers thick , atrophic , parakeratinized and stratified squamous type .
correlating with the clinical and histopathological examination , the excised lesion was suggestive of fibrolipoma [ figure 4 ] .
histologic appearance of fibrolipoma [ h & e , 10 ] postoperative healing of buccal mucosa
the first description of oral lipoma was provided in 1848 by roux in a review of alveolar masses which he referred it as a  yellow epulis  .
the lipoma is a very common benign tumor of adipose tissue , but its presence in the oral and oropharyngeal region is relatively uncommon with a prevalence rate of only 1/5000 adults .
fibrolipoma is a microscopic variant of lipoma characterized by a significant fibrous component intermixed with lobules of fat cells .
the consistency of this lesion varies from soft to firm , depending on the quantity and distribution of fibrous tissue and the depth of the tumor .
the tumor has been reported to be more frequent in the buccal mucosa and buccal vestibule , and it also shows a slight predominance in females . in our case ,
fregnani et al . collected several cases and diagnosed 45.7% cases as lipomas and 39.1% cases as fibrolipomas .
hereditary , fatty degeneration , hormonal basis , trauma , infection , infarction , and chronic irritation are probable representative theories to elucidate the pattern of a lipoma .
the most common of these is the fibrolipoma , characterized by a significant fibrous component intermixed with the lobules of fat cells .
the spindle cell lipoma is another variant that demonstrates variable amount of uniform appearing spindle cells in conjunction with a more typical lipomatous component .
intramuscular lipomas are often more deeply situated and have an infiltrative growth pattern that extends between skeletal muscle bundles .
this tumor can be life threatening due to obstruction of upper airway by virtue of its size as sudden asphyxia death has been reported in a case of esophageal fibrolipoma .
lesions outside the oral cavity could show greater recurrence rates after surgical excision , but intraoral intramuscular lipomas , although not well - limited , rarely show recurrence if completely excised .
most of lipomas develop in the subcutaneous tissues but deeper tissues may be involved as well .
the complete resection should be emphasized , which is the key factor to avoid recurrence .
 the lipoma is a very common benign tumor of adipose tissue , but its presence in the oral and oropharyngeal region is relatively uncommon . 
 fibrolipoma , a histological variant of lipoma , mostly affect the buccal mucosa and causes functional and cosmetic disabilities . 
 hence , accurate histopathological examination of lipomas is important for a correct treatment plan . 
 this article describes a case of 10 year old girl with fibrolipoma of the buccal mucosa with a relevant review of tumors . 
Introduction
Case Report
Discussion
Conclusion