Introduction: Lipoma is a benign tumor infrequent in the oral cavity, particularly in the tongue: indeed, lipomas only represent approximately 0.3% of all tongue neoplasia. Compared to conventional lipoma, fibrolipoma of the tongue is a very rare lesion that accounts for around 25-40% of tongue lipomas, and until now, to the best of our knowledge, only 14 cases have been described in which histological diagnosis of fibrolipoma was specifically confirmed. We report the case of a patient with a voluminous fibrolipoma of the tongue, treated by means of surgical excision. Fibrolipoma excision, like that described in this report, sometimes may be laborious, because fibrous bands appear to be focally infiltrating adjacent tissues, giving rise to some doubts about the nature of the lesion.
Case presentation: We report the case of a voluminous fibrolipoma of the tongue in a 71-year-old Caucasian woman.
Conclusions: Because of its histological characteristics, abundance of connective and secondary changes/atrophy, fibrolipoma may appear as infiltrating adjacent tissues and may cause doubts of differential diagnosis with malignant infiltrating lesions. Surgical excision is the elective treatment. However, an accurate differential diagnosis, postsurgical histological examination and careful follow-up are required.