Lipoma

A lipoma is a benign tumor made of fat tissue.[1] They are

Lipoma
generally soft to the touch, movable, and painless.[1] They usually
occur just under the skin but occasionally may be deeper.[1] Most
are less than 5 cm in size.[2] Common locations include upper
back, shoulders, and abdomen.[4] A few people have a number of
lipomas.[3]

The cause is generally unclear.[1] Risk factors include family

history, obesity, and not enough exercise.[1][3] Diagnosis is
typically based on a physical exam.[1] Occasionally medical
imaging or tissue biopsy is used to confirm the diagnosis.[1]

Treatment is typically by observation or surgical removal.[1]

Rarely the condition may recur following removal, however, this
Lipoma on forearm
can generally be managed with repeat surgery.[1] They are not
Specialty Dermatology, general surgery
generally associated with a future risk of cancer.[1]
Symptoms Soft, movable, usually painless
About 2% of people are affected.[2] Lipomas typically occur in lump[1]
adults between 40 and 60 years of age.[1] Males are more often
Usual onset 40 to 60 years old[1]
affected than females.[1] They are the most common non-
cancerous soft tissue tumor.[5] The first use of the term "lipoma" Types Superficial, deep[2]
to describe these tumors was in 1709.[6] Causes Unclear[1]
Risk factors Family history, obesity,
insufficient exercise[3][1]
Contents Diagnostic Based on physical exam[1]
method
Types
Differential Liposarcoma, hibernoma,
Causes
Other conditions diagnosis lipomatosis[4]

Diagnosis Treatment Observation, surgery[1]

Treatment Prognosis Good[1]
Prognosis Frequency ~2%[2]
Epidemiology
Other animals
References
External links

Types
There are many subtypes of lipomas:[7]:624–5

Adenolipomas are lipomas associated with eccrine sweat glands.[8]:627

Angiolipoleiomyomas are acquired, solitary, asymptomatic acral nodules, characterized histologically by well-
circumscribed subcutaneous tumors composed of smooth muscle cells, blood vessels, connective tissue, and
fat.[7]:627
Angiolipomas are painful subcutaneous nodules having all other features of a typical lipoma.[7]:624[9]
Cerebellar pontine angle and internal auditory canal lipomas[10]
Chondroid lipomas are deep-seated, firm, yellow tumors that characteristically occur on the legs of women.[7]:625
Corpus callosum lipoma is a rare congenital brain condition that may or may not present with symptoms.[11] This
occurs in the corpus callosum, also known as the calossal commissure, which is a wide, flat bundle of neural fibers
beneath the cortex in the human brain.
Hibernomas are lipomas of brown fat.
Intradermal spindle cell lipomas are distinct in that they most commonly affect women and have a wide distribution,
occurring with relatively equal frequency on the head and neck, trunk, and upper and lower extremities.[7]:625[9]
Neural fibrolipomas are overgrowths of fibro-fatty tissue along a nerve trunk, which often leads to nerve
compression.[7]:625
Pleomorphic lipomas, like spindle-cell lipomas, occur for the most part on the backs and necks of elderly men and
are characterized by floret giant cells with overlapping nuclei.[7]:625
Spindle-cell lipomas are asymptomatic, slow-growing subcutaneous tumors that have a predilection for the posterior
back, neck, and shoulders of older men.[7]:625
Superficial subcutaneous lipomas, the most common type of lipoma, lie just below the surface of the skin.[12] Most
occur on the trunk, thigh, and forearm, although they may be found anywhere in the body where fat is located.

Causes
The tendency to develop a lipoma is not necessarily hereditary, although hereditary conditions such as familial multiple
lipomatosis might include lipoma development.[13][14] Genetic studies in mice have shown a correlation between the
HMG I-C gene (previously identified as a gene related to obesity) and lipoma development. These studies support prior
epidemiologic data in humans showing a correlation between HMG I-C and mesenchymal tumors.[15]

Cases have been reported where minor injuries are alleged to have triggered the growth of a lipoma, called "post-
traumatic lipomas."[16] However, the link between trauma and the development of lipomas is controversial.[17]

Other conditions
Lipomatosis is believed to be a hereditary condition in which multiple lipomas are present on the body.

Adiposis dolorosa (Dercum disease) is a rare condition involving multiple painful lipomas, swelling, and fatigue. Early
studies mentioned prevalence in obese postmenopausal women. However, current literature demonstrates that Dercum
disease is present in more women than men of all body types; the average age for diagnosis is 35 years.[18]

Benign symmetric lipomatosis (Madelung disease) is another condition involving lipomatosis. It nearly always appears in
middle-aged males after many years of alcoholism. But, non-alcoholics and females can also be affected.

Diagnosis
A physical exam is typically the easiest way to diagnose it. Rarely, a tissue biopsy or imaging may be required.
 X-ray of the lipoma. Ultrasound image of MRI showing lipoma of X-ray showing lipoma
breast lipoma the arm

Treatment
Usually, treatment of a lipoma is not necessary, unless the tumor becomes painful or restricts movement. They are usually
removed for cosmetic reasons if they grow very large or for histopathology to verify that they are not a more dangerous
type of tumor such as a liposarcoma.[12] This last point can be important as the characteristics of a tumor are not known
until after it is removed and medically examined.

Lipomas are normally removed by simple excision.[19] The removal can often be done under local anesthetic and takes
less than 30 minutes. This cures the great majority of cases, with about 1–2% of lipomas recurring after excision.[20]
Liposuction is another option if the lipoma is soft and has a small connective tissue component. Liposuction typically
results in less scarring; however, with large lipomas it may fail to remove the entire tumor, which can lead to regrowth.[21]

New methods under development are supposed to remove the lipomas without scarring. One is removal by injecting
compounds that trigger lipolysis, such as steroids or phosphatidylcholine.[19][22]

Resection of an intermuscular lipoma in the elbow region

 Intraoperative photo. Operating field after The resected lipoma
removal of the lipoma. (8 cm × 6 cm × 3 cm)
Arrow marks the median
nerve that was
compressed by the
lipoma.

Other lipomas

Lipoma removed from Lipoma removed from This lipoma was

human torso the breast removed from the thigh
of a 39-year-old male
patient. It measured
approximately 10 cm in
diameter at the time of
removal.

Prognosis
Lipomas are rarely life-threatening, and the common subcutaneous lipomas are not a serious condition. Lipomas growing
in internal organs can be more dangerous; for example, lipomas in the gastrointestinal tract can cause bleeding,
ulceration, and painful obstructions (so-called "malignant by location", despite being a benign growth
histologically).[23][24] Malignant transformation of lipomas into liposarcomas is very rare, and most liposarcomas are not
produced from pre-existing benign lesions.[20] A few cases of malignant transformation have been described for bone and
kidney lipomas,[25][26] but it is possible that these few reported cases were well-differentiated liposarcomas in which the
subtle malignant characteristics were missed when the tumor was first examined.[27] Deep lipomas have a greater
tendency to recur than superficial lipomas because complete surgical removal of deep lipomas is not always
possible.[27][28]
The presence of multiple lipomas is known as lipomatosis and is more commonly encountered in men. Some superficial
lipomas can extend into deep fascia and may complicate excision. Liposarcoma is found in 1% of lipomas and is more
likely to occur in lesions of the lower extremities, shoulders, and retroperitoneal areas. Other risk factors for liposarcoma
include large size (>5 cm), associated with calcification, rapid growth, and/or invasion into nearby structures or through
fascia into muscle tissue.[29]

Epidemiology
Approximately two percent of the general population has a lipoma.[2] These tumors can occur at any age, but are most
common in middle age, often appearing in people from 40 to 60 years old.[19] Cutaneous lipomas are rare in children, but
these tumors can occur as part of the inherited disease Bannayan-Zonana syndrome.[30][31]

Lipomas are usually relatively small with diameters of about 1–3 cm,[32] but in rare cases they can grow over several years
into "giant lipomas" that are 10–20 cm across and weigh up to 4–5 kg.[33][34]

Other animals
Lipomas occur in many animals but are most common in older dogs, particularly older Labrador Retrievers, Doberman
Pinschers, and Miniature Schnauzers.[35] Overweight female dogs are especially prone to developing these tumors, and
most older or overweight dogs have at least one lipoma.[36][37] In dogs, lipomas usually occur in the trunk or upper
limbs.[35] Lipomas are also found less commonly in cattle and horses, and rarely in cats and pigs.[37][38] However, a
pedunculated lipoma can cause entrapment and torsion of the intestine in horses, causing necrosis, colic, and possibly
death. The intestine becomes wound around the stalk of the lipoma and loses blood supply.[39]

References
1. "Lipoma-OrthoInfo - AAOS" (http://orthoinfo.aaos.org/topic.cfm?topic=a00631). orthoinfo.aaos.org. May 2012.
Retrieved 8 November 2017.
2. Kransdorf, Mark J.; Murphey, Mark D. (2006). Imaging of Soft Tissue Tumors (https://books.google.ca/books?id=0ZA
6ntBA76MC&pg=PA81). Lippincott Williams & Wilkins. p. 81. ISBN 9780781747714.
3. Fletcher, Christopher D. M.; Unni, K. Krishnan; Mertens, Fredrik (2002). Pathology and Genetics of Tumours of Soft
Tissue and Bone (https://books.google.ca/books?id=dg9am0g4EP8C&pg=PA20). IARC. p. 20.
ISBN 9789283224136.
4. Lindberg, Matthew R. (2015). Diagnostic Pathology: Soft Tissue Tumors E-Book (https://books.google.ca/books?id=a
SZACgAAQBAJ&lpg=RA1-PR15&dq=Lipoma%20%22differential%20diagnosis%22&pg=PA44). Elsevier Health
Sciences. p. 44. ISBN 9780323400411.
5. Bancroft LW, Kransdorf MJ, Peterson JJ, O'Connor MI (October 2006). "Benign fatty tumors: classification, clinical
course, imaging appearance, and treatment". Skeletal Radiol. 35 (10): 719–33. doi:10.1007/s00256-006-0189-y (http
s://doi.org/10.1007/s00256-006-0189-y). PMID 16927086 (https://www.ncbi.nlm.nih.gov/pubmed/16927086).
6. Olson, James Stuart (1989). The History of Cancer: An Annotated Bibliography (https://books.google.ca/books?id=o
AX8jOJ9uO0C&pg=PA15). ABC-CLIO. p. 15. ISBN 9780313258893.
7. James, William D.; Berger, Timothy G.; Elston, Dirk M. (2005). Andrews' Diseases of the Skin: Clinical Dermatology
(10th ed.). London: Elsevier. ISBN 0-7216-2921-0.
8. James, William D.; Berger, Timothy G.; Elston, Dirk M. (2011). Andrews' Diseases of the Skin: Clinical Dermatology
(11th ed.). London: Elsevier. ISBN 9781437703146.
 9. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby.
p. 1838. ISBN 1-4160-2999-0.
10. Crowson MG, Symons SP, Chen JM. "Left cerebellopontine angle lipoma with mild brainstem compression in a 13-
year-old female". Otology & Neurotology. doi:10.1097/mao.0b013e3182814d6e (https://doi.org/10.1097/mao.0b013e
3182814d6e).
11. Wallace D (December 1976). "Lipoma of the corpus callosum" (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC49256
2). J Neurol Neurosurg Psychiatry. 39 (12): 1179–85. doi:10.1136/jnnp.39.12.1179 (https://doi.org/10.1136/jnnp.39.12
.1179). PMC 492562 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC492562)​ . PMID 1011028 (https://www.ncbi.nlm
.nih.gov/pubmed/1011028).
12. Lipomas (http://www.emedicine.com/med/topic2720.htm#) at eMedicine
13. Leffell DJ, Braverman IM (August 1986). "Familial multiple lipomatosis. Report of a case and a review of the
literature". J. Am. Acad. Dermatol. 15 (2 Pt 1): 275–9. doi:10.1016/S0190-9622(86)70166-7 (https://doi.org/10.1016/S
0190-9622%2886%2970166-7). PMID 3745530 (https://www.ncbi.nlm.nih.gov/pubmed/3745530).
14. Toy BR (October 2003). "Familial multiple lipomatosis" (http://dermatology.cdlib.org/94/NYU/Jan2002/2.html).
Dermatol. Online J. 9 (4): 9. PMID 14594582 (https://www.ncbi.nlm.nih.gov/pubmed/14594582).
15. Arlotta P, Tai AK, Manfioletti G, Clifford C, Jay G, Ono SJ (May 2000). "Transgenic mice expressing a truncated form
of the high mobility group I-C protein develop adiposity and an abnormally high prevalence of lipomas". J Biol Chem.
275 (19): 14394–400. doi:10.1074/jbc.M000564200 (https://doi.org/10.1074/jbc.M000564200). PMID 10747931 (https
://www.ncbi.nlm.nih.gov/pubmed/10747931).
16. Signorini M, Campiglio GL (March 1998). "Posttraumatic lipomas: where do they really come from?". Plast. Reconstr.
Surg. 101 (3): 699–705. doi:10.1097/00006534-199803000-00017 (https://doi.org/10.1097/00006534-199803000-000
17). PMID 9500386 (https://www.ncbi.nlm.nih.gov/pubmed/9500386).
17. Aust MC, Spies M, Kall S, Jokuszies A, Gohritz A, Vogt P (2007). "Posttraumatic lipoma: fact or fiction?" (http://www.l
ejacq.com/articleDetail.cfm?pid=SKINmed_6;6:266). Skinmed. 6 (6): 266–70. doi:10.1111/j.1540-9740.2007.06361.x
(https://doi.org/10.1111/j.1540-9740.2007.06361.x). PMID 17975353 (https://www.ncbi.nlm.nih.gov/pubmed/1797535
3).
18. http://www.lipomadoc.org/uploads/5/0/4/8/5048532/dd_white_paper.pdf
19. Salam GA (March 2002). "Lipoma excision" (http://www.aafp.org/afp/20020301/901.html). Am Fam Physician. 65 (5):
901–4. PMID 11898962 (https://www.ncbi.nlm.nih.gov/pubmed/11898962).
20. Dalal KM, Antonescu CR, Singer S (March 2008). "Diagnosis and management of lipomatous tumors". J Surg Oncol.
97 (4): 298–313. doi:10.1002/jso.20975 (https://doi.org/10.1002/jso.20975). PMID 18286473 (https://www.ncbi.nlm.ni
h.gov/pubmed/18286473).
21. Al-basti HA, El-Khatib HA (2002). "The use of suction-assisted surgical extraction of moderate and large lipomas:
long-term follow-up". Aesthetic Plast Surg. 26 (2): 114–7. doi:10.1007/s00266-002-1492-1 (https://doi.org/10.1007/s0
0266-002-1492-1). PMID 12016495 (https://www.ncbi.nlm.nih.gov/pubmed/12016495).
22. Bechara FG, Sand M, Sand D, et al. (2006). "Lipolysis of lipomas in patients with familial multiple lipomatosis: an
ultrasonography-controlled trial". J Cutan Med Surg. 10 (4): 155–9. doi:10.2310/7750.2006.00040 (https://doi.org/10.
2310/7750.2006.00040). PMID 17234112 (https://www.ncbi.nlm.nih.gov/pubmed/17234112).
23. Thompson WM (1 April 2005). "Imaging and findings of lipomas of the gastrointestinal tract" (http://www.ajronline.org/
cgi/pmidlookup?view=long&pmid=15788588). AJR Am J Roentgenol. 184 (4): 1163–71.
doi:10.2214/ajr.184.4.01841163 (https://doi.org/10.2214/ajr.184.4.01841163). PMID 15788588 (https://www.ncbi.nlm.
nih.gov/pubmed/15788588).
24. Taylor AJ, Stewart ET, Dodds WJ (1 December 1990). "Gastrointestinal lipomas: a radiologic and pathologic review" (
http://www.ajronline.org/cgi/pmidlookup?view=long&pmid=2122666). AJR Am J Roentgenol. 155 (6): 1205–10.
doi:10.2214/ajr.155.6.2122666 (https://doi.org/10.2214/ajr.155.6.2122666). PMID 2122666 (https://www.ncbi.nlm.nih.
gov/pubmed/2122666).
25. Milgram JW (1990). "Malignant transformation in bone lipomas". Skeletal Radiol. 19 (5): 347–52.
 doi:10.1007/BF00193088 (https://doi.org/10.1007/BF00193088). PMID 2165632 (https://www.ncbi.nlm.nih.gov/pubm
ed/2165632).
26. Lowe BA, Brewer J, Houghton DC, Jacobson E, Pitre T (May 1992). "Malignant transformation of angiomyolipoma".
J. Urol. 147 (5): 1356–8. PMID 1569683 (https://www.ncbi.nlm.nih.gov/pubmed/1569683).
27. Goldblum, John R.; Weiss, Sharon W.; Enzinger, Franz M. (2008). Enzinger and Weiss's soft tissue tumors (5th ed.).
Mosby Elsevier. ISBN 0-323-04628-2.
28. Fletcher, C.D.M., Unni, K.K., Mertens, F. (2002). Pathology and Genetics of Tumours of Soft Tissue and Bone. World
Health Organization Classification of Tumours. 4. Lyon: IARC Press. ISBN 92-832-2413-2.
29. E.J. Mayeaux Jr. (2009). The Essential Guide to Primary Care Procedures (https://books.google.com/books?id=d-wN
b7eyonMC&pg=PA386&lpg=PA386&dq=can+lipoma+penetrate+fascia&source=bl&ots=MWiVe3ZS4R&sig=1a5ULhG
78-1QQ2Gq6JPXutxM3h0&hl=en&sa=X&ei=nOf_UpC8I43Ksga9kYCoDw&ved=0CCYQ6AEwAA#v=onepage&q=can
%20lipoma%20penetrate%20fascia&f=false), p.386, Wolters Kluwer Health. ISBN 978-0-7817-7390-4.
30. Buisson P, Leclair MD, Jacquemont S, et al. (September 2006). "Cutaneous lipoma in children: 5 cases with
Bannayan-Riley-Ruvalcaba syndrome". J. Pediatr. Surg. 41 (9): 1601–3. doi:10.1016/j.jpedsurg.2006.05.013 (https://
doi.org/10.1016/j.jpedsurg.2006.05.013). PMID 16952599 (https://www.ncbi.nlm.nih.gov/pubmed/16952599).
31. Gujrati M, Thomas C, Zelby A, Jensen E, Lee JM (August 1998). "Bannayan-Zonana syndrome: a rare autosomal
dominant syndrome with multiple lipomas and hemangiomas: a case report and review of literature" (http://linkinghub.
elsevier.com/retrieve/pii/S0090-3019(98)00039-1). Surg Neurol. 50 (2): 164–8. doi:10.1016/S0090-3019(98)00039-1
(https://doi.org/10.1016/S0090-3019%2898%2900039-1). PMID 9701122 (https://www.ncbi.nlm.nih.gov/pubmed/970
1122).
32. Lipoma—topic overview (http://www.webmd.com/skin-problems-and-treatments/tc/lipoma-topic-overview) at
webmd.com
33. Hakim E, Kolander Y, Meller Y, Moses M, Sagi A (August 1994). "Gigantic lipomas". Plast. Reconstr. Surg. 94 (2):
369–71. doi:10.1097/00006534-199408000-00025 (https://doi.org/10.1097/00006534-199408000-00025).
PMID 8041830 (https://www.ncbi.nlm.nih.gov/pubmed/8041830).
34. Terzioglu A, Tuncali D, Yuksel A, Bingul F, Aslan G (March 2004). "Giant lipomas: a series of 12 consecutive cases
and a giant liposarcoma of the thigh". Dermatol Surg. 30 (3): 463–7. doi:10.1111/j.1524-4725.2004.30022.x (https://d
oi.org/10.1111/j.1524-4725.2004.30022.x). PMID 15008886 (https://www.ncbi.nlm.nih.gov/pubmed/15008886).
35. Adipose Tissue Tumors (http://merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/72220.htm) The Merck Veterinary
Manual, (9th ed.)
36. Lipomas (http://www.purinaone.com.au/Article/articledetails.aspx?id=753) Veterinary & Aquatic Services Department,
Purina
37. Lipoma (http://education.vetmed.vt.edu/curriculum/vm8304/lab_companion/histo-path/introhistopath/Lab9/Lesions/lip
oma.htm) Virginia Polytechnic Institute and State University
38. Lipomas (Fatty Tumors) (http://vetmedicine.about.com/cs/dogdiseasesl/a/lipomas.htm) Veterinary Q & A
39. The Merck Veterinary Manual (9th ed.). Merial. 2005. ISBN 0911910506.
External links
humpath #2626 (http://www.humpath.com/spip.php?page=article&id_article Classification ICD-10: D17 (http:/ D
=2626) /apps.who.int/classif
ications/icd10/brows
e/2016/en#/D17)
(ILDS D17.910) ·
ICD-9-CM: 214 (http
://www.icd9data.co
m/getICD9Code.ash
x?icd9=214) ·
MeSH: D008067 (ht
tps://www.nlm.nih.g
ov/cgi/mesh/2015/M
B_cgi?field=uid&ter
m=D008067) ·
DiseasesDB: 7493
(http://www.disease
sdatabase.com/ddb
7493.htm)
External MedlinePlus:
resources 003279 (https://ww
w.nlm.nih.gov/medli
neplus/ency/article/
003279.htm) ·
eMedicine:
med/2720 (http://ww
w.emedicine.com/m
ed/topic2720.htm)
derm/242 (http://ww
w.emedicine.com/de
rm/topic242.htm#) ·
Patient UK: Lipoma
(https://patient.info/d
octor/lipoma)
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