Symmetrical lipomatosis of the tongue: Case report and literature review

- We report a case of symmetric lipomatosis of the tongue (SLT), its etiology, clinical findings, and management considerations.
- SLT has been considered as occurring with multiple symmetric lipomatosis (MSL) by several authors; we suggest that SLT occurs mostly alone and isolated from MSL and not in conjunction with MSL.
- MSL is characterized by a wide distribution of plasma cholesterol values, associated with an increase in plasma levels of high-density lipoprotein cholesterol and decrease in plasma levels of low-density lipoprotein cholesterol.
- Future studies should analyze whether presence of hyperalphalipoproteinemia occurs in SLT and compare this with MSL.

Multiple symmetric lipomatosis is rare and characterized by diffuse growth and nonencapsulated lipomas. It is usually found in the posterior neck and upper trunk, and the entity is known as “benign symmetric lipomatosis,” “Madelung disease,” and “Launois-Bensaude syndrome.” Symmetric lipomatosis of the tongue was first described by Desmond and is an extremely rare condition. A 74-year-old man complained of painless tongue swelling and difficulty speaking. Clinical findings revealed no tumor masses on the trunk, limbs, or head and neck region. Intraoral findings included soft yellowish masses with a smooth surface without erosions on the side of the tongue bilaterally. They were 30 mm in diameter. An incisional biopsy was taken from the mass, and the lipoma was diagnosed. The bilateral tongue lesions were resected under general anesthesia. Intraoperative findings revealed adipose tissues interspersed with lingual muscles and no capsulation. The lesion was finally diagnosed as symmetric lipomatosis of the tongue based on clinical findings and radiological and histologic examination.