Diode Laser Excision of Chondroid Lipoma of the Tongue with Microscopic (Conventional and Confocal Laser Scanning) Analysis

Abstract

We describe a case of chondroid lipoma of the oral mucosa, which represents an unusual histological type of oral lipoma. Though its use is still debated, we used a diode laser to perform complete excision of the lesion, and histologically analyzed the specimen. Lipomas represent 0.1-5% of all benign oral neoplasms. Chondroid lipoma is a rare histological type first described in 1993; only a few cases have been described in the literature. Its clinical diagnosis is difficult because the clinical appearance is not specific. The lesion was excised by diode laser and the specimen was histologically evaluated using both conventional and confocal laser scanning microscopy. The final diagnosis was lipoma (chondroid variant). Diode laser had several benefits in the clinical application and in the histological evaluation due to the lack of morphological and structural alterations of the surgical specimen. We maintain that the diode laser is a useful electromedical device for surgery on both benign and malignant oral lesions, though good practice is mandatory in order to apply the best parameters to the clinical situation. When the preoperative biopsy is not performable because of small dimension, as in the reported case, surgical excision of all nodular lesions of the oral mucosa should be performed with lateral and deep margins distant from the central lesion. This prevents possible complications related to a possible final diagnosis of malignant neoplasm; in fact, the differential diagnosis in the reported case also included liposarcoma.