Oral functional impairments associated with large sublingual angiolipoma

A male patient in his late 50s presented with a long-standing, painless sublingual mass causing progressive impairment of speech, mastication, swallowing and intermittent respiratory discomfort due to restricted tongue mobility. An MRI demonstrated a well-circumscribed lipomatous lesion without evidence of significant vascular involvement, suggesting a conventional lipoma and facilitating surgical planning; however, definitive diagnosis remained uncertain preoperatively. The lesion was successfully excised through a transoral approach under intravenous sedation and local anaesthesia, with complete functional recovery and no recurrence during 6 months of follow-up. Histopathological examination established the diagnosis of angiolipoma, highlighting the limitations of imaging in distinguishing lipomatous tumour subtypes and the importance of histopathological confirmation. This case emphasises that large benign lesions of the floor of the mouth may cause substantial functional impairment despite their indolent course, making timely recognition and surgical management essential.