Lipomas are benign soft tissue tumors that are ubiquitous in nature. Available literature suggests that benign tumors are harmless unless they increase in size, resulting in compression of vital structures. This case report discusses the case of a 52-year-old man who presented to the clinic with a painless, growing lump on the right side of his mouth. The patient\'s symptoms included difficulty swallowing and speaking, which led the doctors to recommend surgical excision of the mass. There were no issues during the mass removal surgery, and the incision healed without compromising the lingual or hypoglossal nerves or Wharton\'s duct, as observed during follow-up visits. Patient history, symptoms, preoperative examination, treatment strategy, and surgical technique are all included in this case study, which focuses on the extremely unusual development of lipomas in the oral cavity, particularly on the floor of the mouth.

Lipomas are one of the most common benign connective tissue masses in the human body. They rarely cause issues and are typically removed for cosmetic reasons. They rarely appear in the oral cavity though they are common. Thus, only a few sublingual lipoma cases have been reported. We present a case of a male in his 60s who came to our clinic complaining of dysphagia and dysarthria caused by an oral swelling from a right sublingual simple lipoma. It was decided to be removed surgically under general anesthesia, with neuromonitoring of the right hypoglossal nerve. The patient tolerated the surgery without complications and fully recovered with complete resolution of his mass effect symptoms. This case demonstrated the importance of having a wide differential diagnosis of oral lesions, especially in a patient with a complicated medical history. Though it is not used often, the case also demonstrated the neuroprotective effect of intraoperative hypoglossal nerve monitoring during sublingual surgeries.