Giant Lipoma of the Temporal Region Extending Into the Buccal Space: Radiologic, Surgical, and Molecular Correlation

Lipomas are common benign tumors of adipose tissue; however, their occurrence in the head and neck region, particularly within deep facial compartments, is relatively uncommon. Lesions arising in the buccal space may pose diagnostic and surgical challenges due to their proximity to critical anatomic structures. A 69-year-old female presented with a gradually enlarging, painless swelling of the right midface, resulting in facial asymmetry. Clinical examination identified a soft, mobile mass without neurological deficit. Magnetic resonance imaging revealed a well-circumscribed lesion within the right buccal space, with signal characteristics consistent with adipose tissue. Surgical excision was performed, and the specimen measured 8.5 × 5.5 × 2 cm. Histopathologic analysis confirmed a benign lipoma composed of mature adipocytes without atypia. Molecular assessment using fluorescence in situ hybridization showed no MDM2 gene amplification, ruling out an atypical lipomatous tumor. The postoperative course was uneventful, with preservation of facial nerve function and a satisfactory aesthetic result. Lipomas of deep facial compartments are uncommon and may mimic other pathologies. Accurate diagnosis relies on correlation of clinical findings with imaging, histopathology, and, when necessary, molecular analysis. Surgical excision remains the treatment of choice and is associated with favorable outcomes.