Treatment

Under general anesthesia an incision was made through the posterior tongue to release a circumscribed yellow nodule (Figure 3). The soft tissue nodule was bluntly and circumferentially enucleated. It shelled out intact as an encapsulated yellow nodule (Figure 4) of about 3.5 cm in greatest dimensions. The nodule was soft, and upon sectioning it was yellow and glistening. The surgical site was closed with Vicryl suture. The area healed well.

Figure 3 This is a clinical photograph of the lesion at surgery demonstrating a yellow nodule emerging from the site of incision.

Figure 4 This is a gross photograph of the encapsulated yellow nodule after it was removed from the posterior tongue.

Excisional Biopsy

The histology was diagnosed by Dr. Diane Jordan, Cellnetix Pathology, Seattle, WA. Histologic evaluation revealed a multisected and encapsulated neoplasm composed of lobules of mature adipocytes suspended on delicate collagen fibers and small blood vessels (Figure 5 & 6). The neoplasm is surrounded by a thin capsule made up of a few layers of fibrous connective tissue.

Figure 5 Low power (x100) H & E stained histology shows a benign neoplasm of adipose tissue origin. It is lobular and composed of mature adipocytes suspended on delicate collagen fibers. The adipose tissue is focally infiltrating skeletal muscle bundles.

Figure 6 High power (x200) H & E stained histology shows a closer look at the mature adipocytes suspended on a delicate background of connective tissue.