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Background <p>Spindle cell lipoma (SCL) is a rare benign adipocytic neoplasm in the oral cavity, and floor-of-mouth involvement is exceptional. Its nonspecific clinical presentation can mimic ranula, salivary gland tumors, and other lipomatous lesions.</p> Case Presentation <p>We report two women, aged 53 and 73 years, with painless submucosal masses on the floor of the mouth. Both lesions were excised with the involved sublingual gland. Histology showed bland spindle cells admixed with mature adipose tissue and collagenous stroma. Immunohistochemistry demonstrated CD34 positivity, adipocyte-restricted S-100 expression, low Ki-67 indices, and variable Rb loss; myogenic and epithelial markers were negative. MDM2/CDK4 testing was not performed.</p> Discussion <p>Clinicopathological correlation supported a diagnosis of SCL and helped distinguish these lesions from atypical lipomatous tumor/well-differentiated liposarcoma. In diagnostically equivocal cases, molecular testing for MDM2/CDK4 should be considered.</p> Conclusion <p>SCL should be included in the differential diagnosis of slow-growing floor-of-mouth masses. No recurrence was observed at 3 months, but late recurrence cannot be excluded because follow-up remains short.</p>

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Spindle Cell Lipoma of the Floor of the Mouth: A Report of Two Cases

  • 期刊论文

  • 发表日期：

    2026年8月3日

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  • Xudong Chen,
  • Meng Wang,
  • Haoyue Xu,
  • Dongpo Li,
  • Lin Wang,
  • Shuangyi Wang,
  • Haijun Zhao

摘要

Background

Spindle cell lipoma (SCL) is a rare benign adipocytic neoplasm in the oral cavity, and floor-of-mouth involvement is exceptional. Its nonspecific clinical presentation can mimic ranula, salivary gland tumors, and other lipomatous lesions.

Case Presentation

We report two women, aged 53 and 73 years, with painless submucosal masses on the floor of the mouth. Both lesions were excised with the involved sublingual gland. Histology showed bland spindle cells admixed with mature adipose tissue and collagenous stroma. Immunohistochemistry demonstrated CD34 positivity, adipocyte-restricted S-100 expression, low Ki-67 indices, and variable Rb loss; myogenic and epithelial markers were negative. MDM2/CDK4 testing was not performed.

Discussion

Clinicopathological correlation supported a diagnosis of SCL and helped distinguish these lesions from atypical lipomatous tumor/well-differentiated liposarcoma. In diagnostically equivocal cases, molecular testing for MDM2/CDK4 should be considered.

Conclusion

SCL should be included in the differential diagnosis of slow-growing floor-of-mouth masses. No recurrence was observed at 3 months, but late recurrence cannot be excluded because follow-up remains short.