Angiolipoma in the Head and Neck: Imaging, Diagnosis and Management

Angiolipoma, distinguishable from other lipomas by its excessive degree of vascular vessels, are rare in the head and neck and require unique management. A slow growing mass, located underneath the inferior border of the right mandibular angle of a 51-year-old female, was excised under general anesthesia. Unexpected excessive bleeding during the excision was observed and the histological specimen was diagnosed as angiolipoma. As shown in this case report, pre-operative imaging modalities have a crucial influence and are sufficient to diagnose and manage angiolipomas. The “Gold standard” treatment is excision with clear margins and bleeding management should be taken into account according to appropriate differential diagnosis.

Angiolipoma in head and neck: report of two cases and review of the literature

Angiolipomas are either encapsulated or non-encapsulated fatty tumours. They are distinguished from other lipomas by the excessive degree of vascular proliferation and because they are mixed with mature adipocytes. They commonly occur in the trunk and extremities and are rare in the maxillofacial area. Only 36 cases in the head and neck have been reported in the literature. The authors report the first non-infiltrating intramasseterine angiolipoma, and a case of non-infiltrating angiolipoma of the cheek. These tumours appear as homogenous low-density areas on CT with no contrast enhancement. MRI gives better tumour delineation and clear definition of the location and longitudinal extent of the mass. Histopathology demonstrates mature adipose tissue and the proliferation of numerous small branching blood vessels. Management of angiolipomas requires complete surgical excision.

Non-infiltrating angiolipoma of the cheek: a case report and review of the literature

Angiolipoma, spindle cell lipoma, mylelolipoma, chondrolipoma and myxolipoma are histologic variants of lipomas arising from fat tissue. Although angiolipoma is the most common tumor in the trunk and extremities of young people, it occurs infrequently in the head and neck region. The authors present the clinical and histological features of a non-infiltrating angiolipoma excised from the cheek of a 22-year old man. Clinical examination showed a soft, mobile, approximately 4 x 3 cm mass that could be palpated anterior to the masseter muscle. The mass was removed by an intraoral approach. Angiolipoma was confirmed on histopathologic evaluation. Lipomas represent about 1 to 5% of all neoplasms of the oral cavity. They are usually painless, soft, round and mobile. The diagnosis is based on both clinical and histologic characteristics. The treatment is surgical excision.