Table 1 Differential diagnosis of lipoma of the vestibular region in the oral cavity [1,2,3,4,5, 8]

Fibroma

> 20 years old

Same incidence

- Mucosa

- Tongue

Pink, firm, could be ulcerated

Stratified squamous lining covering dense connective tissue

Lymph-angioma

Congenital

Mostly children

Same incidence

- Anterior 2/3 of the tongue

- Center of the tongue

- Buccal mucosa

Hypo-chromatic sometimes purple mass

Could cause difficulty swallowing and interfere in phonation

Dilation of lymphatic vessels

Rhabdo-myosarcoma

Fourth and fifth decades

More in females

Lip, tongue, buccal mucosa

Slow growing, asymptomatic, firm

Numerous thin-walled vessels

Muscle bundles

Neuroma

Second to fifth decades

Same incidence

Tongue, palate buccal mucosa

Semi-elastic consistency, firm, mobile, painful on palpation

Remanence of nerve endings

Double cell distribution histological pattern: Antoni A, Antoni B

Dermoid cyst

Congenital

Same incidence

Tongue, lip, palate

Mobile slow-growing, painless

Problems in speech and swallowing

Keratinized stratified squamous epithelioma

Follicles, sweat, and sebaceous glands

Benign tumors of minor glands

Forth decade

Female more than male

Palate

Mobile, slow-growing, and painless

Isolated lesion

Histological variable

Epithelial component

Large number of patterns

Mucoceles

First and second decade

Same incidence

Lip, buccal mucosa, floor of the mouth

Sessile, fluctuating, painless, rapidly growing mass

Cyst wall without epithelial lining

Hemangioma

Congenital (children)

Same incidence

Lip

Tongue

Buccal mucosa

Reddish or bluish lesion, the compression of the lesion produces whitish aspect which could lead to ischemia

Capillary hemangioma. (capillary of endothelial origin): superficial

Cavernous hemangioma, poorly defined

Mixed hemangioma