Lipomas are among the most common of soft tissue tumors, but they rarely occur in the oral cavity (2.2%). The most common site of occurrence is the cheek, followed by the tongue, lips, and gingiva; the oral floor is a relatively unusual site. The patient was a 74-year-old man, who had first become aware of swelling of the oral floor without any other symptoms about 19 years earlier. He preferred not to have it examined further, but have it monitored over time instead. However, the mass increased in size over time, causing difficulty in speech, eating and closing of the mouth. Finally, he decided to undergo surgery. The tumor was completely excised via the transoral approach. The mass was 70 mm in diameter. Histopathological examination confirmed the tumor as a lipoma. This is the largest lipoma in the oral cavity reported over the last decade in Japan. Even if it begins as a small and asymptomatic tumor, lipoma of the oral floor may grow to a large size and become symptomatic, causing difficulty in speech and eating. Thus, lipomas of the oral floor should be managed surgically as soon as possible.
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