Article # 405. Lipoma

What is a lipoma?

A lipoma is a growth of fat cells in a thin, fibrous capsule usually found just below the skin. Lipomas are found most often on the torso, neck, upper thighs, upper arms, and armpits, but they can occur almost anywhere in the body. One or more lipomas may be present at the same time. Lipomas are the most common noncancerous soft tissue growth.

A lipoma isn't cancer and is usually harmless. Treatment generally isn't necessary, but if the lipoma bothers you, is painful or is growing, you may want to have it removed.

Symptoms

Lipomas are:

·         Situated just under your skin. They commonly occur in the neck, shoulders, back, abdomen, arms and thighs.

·         Soft and doughy to the touch. They also move easily with slight finger pressure.

·         Generally small. Lipomas are typically less than 2 inches (5 centimeters) in diameter, but they can grow larger.

·         Sometimes painful. Lipomas can be painful if they grow and press on nearby nerves or if they contain many blood vessels.

Lipomas usually:

·         Are small [0.4 in. (1 cm) to 1.2 in. (3 cm)] and felt just under the skin.

·         Are movable and have a soft, rubbery consistency.

·         Do not cause pain.

·         Remain the same size over years or grow very slowly.

Often the most bothersome symptom is the location or increased size that makes the lipoma noticeable by others.

Causes:

The exact cause of lipomas is unknown. Lipomas tend to run in families, so genetic factors likely play a role in their development.

Risk Factors:

·         Being between 40 and 60 years old. Although lipomas can occur at any age, they're most common in this age group. Lipomas are rare in children.

·         Having certain other disorders. People with other disorders, including adiposis dolorosa, Madelung disease, Cowden syndrome and Gardner's syndrome, have an increased risk of multiple lipomas.

Preparing your appointment

You're likely to start by seeing your family doctor or a general practitioner. You may then be referred to a doctor who specializes in skin disorders (dermatologist).

Here's some information to help you get ready for your appointment and know what to expect from your doctor.

What you can do

·         Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.

·         Make a list of all medications, vitamins or supplements you're taking.

·         Write down questions to ask your doctor.

Preparing a list of questions can help you make the most of your time with your doctor. For lipoma, some basic questions to ask your doctor include:

·         What caused this growth?

·         Is it cancer?

·         Do I need any tests to be sure?

·         Will this lump always be there?

·         Can I have it removed?

·         What's involved in having it removed? Are there any risks?

·         Is it likely to return, or am I likely to get another?

·         Are there brochures or other resources I can take with me? What websites do you recommend?

Don't hesitate to ask other questions that occur to you.

What to expect from your doctor. Your doctor is likely to ask you questions, too, including:

·         When did you first notice the lump?

·         Has it grown?

·         Have you had similar growths in the past?

·         Is the lump painful?

·         Have others in your family had similar lumps?

Test and Diagnosis

To diagnose a lipoma, your doctor may perform:

·         A physical exam

·         A tissue sample removal (biopsy) for lab examination

·         An ultrasound or other imaging test, such as an MRI or CT scan, if the lipoma is large, has unusual features or appears to be deeper than the fatty tissue

There's a very small chance that a lump resembling a lipoma may actually be a form of cancer called liposarcoma. Liposarcomas — cancerous tumors in fatty tissues — grow rapidly, don't move under the skin and are usually painful. A biopsy, MRI or CT scan is typically done if your doctor suspects liposarcoma.

Treatments and Drugs

No treatment is usually necessary for a lipoma. However, if the lipoma is in a location that bothers you, is painful or is growing, your doctor might recommend that it be removed. Lipoma treatments include:

·         Surgical removal. Most lipomas are removed surgically by cutting them out. Recurrences after removal are uncommon.

·         Steroid injections. This treatment shrinks the lipoma but usually doesn't completely eliminate the tumor.

·         Liposuction. This treatment uses a needle and a large syringe to remove the fatty lump.