Lipoma

What is lipoma ?

Lipoma is a benign extra growth of fat cells, just between the skin and the underlying layer of muscle. It is a non-cancerous growth of soft tissues, which appear like a fibrous capsule.  Lipoma is a fatty lump which has a slow growth. One can feel it doughy by one’s touch and can find it moving readily.

Lipoma can occur at any age and to any person. But generally it occurs to middle aged people in the age group between 40 and 60 years. The rate of occurrence is 1 in 100. It is normal for individuals in this age group to have one or two lipoma growths in his/her body. But some inherit the tendency to bear several of them all over the body. In few cases the lipoma occurs inside the body also, which remain unknown to them, as it does not create any problem. Depending on the location, the internal lipoma can be dangerous. For example, a lipoma in the gastrointestinal tract can cause bleeding, ulceration and painful obstruction.

Symptoms of Lipoma

• In an uncommon condition, groups of fat cells gather under the skin and cause multiple fatty lumps which happen due to genetic heredity and generally tend to run in families. Deeper lipoma can recur.
• Lipoma is not a cancer and as such it is harmless. Hence no treatment is required. Lipoma can occur as a single or multiple growths.
• If the lipoma is giving pain due to its location or growing continuously, or causes cosmetic damage and ugliness, then it can be easily removed surgically.
• Lipoma commonly occurs in shoulders, neck, abdomen, arms, thighs and back. Generally it is small and less than 5cm in size. But it can grow larger.
• Lipoma can be painful if they happen to grow and press the nearby nerves.

When to consult a doctor

Though the lipoma does not create a serious medical condition, it will be better to consult a doctor whenever one notices the growth of a lump on skin.

Types of Lipoma

The subtypes of lipoma are:

• Angiolipoleiomyoma: It is an acquired, asymptomatic acral nodule, solitary tumor. It is a combination of smooth muscle cells, fat, connective tissues and blood vessels.
• Chondroid lipomas: These are deep rooted, firm, yellow tumors, which occur on the legs of women.
• Angiolipoma: It is a painful subcutaneous nodule, possessing all the features of a lipoma.
• Corpus callosum lipoma: It is a rare congenital condition, with growths that are relatively small with 1-3cm diameters and which can grow up to 10 to 20 cm, and can weigh up to 4-5 kilograms.
• Intradermal spindle cell lipoma: Commonly it affects the women, occurs on head, neck, upper and lower extremities and trunk, and has wide distribution.
• Hibernoma: It is a lipoma of brown fat.
• Neural fibrolipoma: It is an overgrowth of fibro-fatty tissue along a nerve trunk, often leading to nerve compression.
• Superficial subcutaneous lipoma: It is the most common type of lipoma which develops just below the skin. It can occur on any part of the body wherever the fat is present. However the trunk, thighs and forearms are the common places that are prone to this type of lipoma
• Pleomorphic lipomas: Elderly men are affected by this lipoma, which occurs mostly on the neck and back.
• Spindle-cell lipoma: It is a slow growing, asymptomatic, subcutaneous tumor, which occurs mostly on the neck, back and shoulders of aged men.

Causes of Lipoma

The exact cause for lipoma is unknown.  However, the lipoma tends to be passed on in families. One can safely conclude that the genetic factors are prone to have its role in the development of lipoma.

A minor injury can trigger the growth of lipoma. Normally, obesity or overweight does not cause lipoma.

The risk factors for developing lipoma are as follows:

• Age factor: Generally lipoma affects the middle aged between 40 to 60 years of age. It rarely affects children
• Persons with other disorders: People with Gardner’s syndrome, adiposis dolorosa, Madelung disease and Cowden syndrome, are more prone to get lipoma.
• Adiposis dolorosa: This type of lipoma is generally seen in obese and post- menopausal women, which causes swelling and fatigue.
• A condition of benign symmetric lipomatosis is seen among men who have been alcoholic for several years. But it can affect others also.

Diagnosis of Lipoma

• A physical exam is performed by the doctor
• Examining of a biopsy tissue sample in a lab
• Ultrasound and other imaging tests, such as MRI and CT scan may be needed if the lipoma is deep, with unusual features and if the size of the lump is larger.
• There are rare chances that a liposarcoma resembles a lipoma. Liposarcomas are cancerous tumors in fatty tissues, which are painful, do not move under the skin and grow quickly.

Lipoma removal, treatment

Lipoma does not warrant treatment unless the tumor becomes a constraint for movement or becomes sore. In most cases, lipoma removal is for cosmetic reasons.

A simple excision process is enough to remove lipoma, this is done under local anesthesia and the process should take less than half an hour. The success rate is high and only in 2 percent of cases, there is a chance of a recurrence.

Liposuction is also another option that can be exercised if the lipoma is soft. Though it does not cause much scarring, the lipomas that become large may re-grow again. To ensure that lipoma removal is done without scarring, there are newer techniques that are getting popular with doctors. One of them is use of steroids or phosphatidylcholine, compounds that are inject to trigger lipolysis (breakdown of lipids).

• Liposuction: Under this treatment, a needle and a syringe is used to remove the fatty lump.
• Surgical removal: The lipomas are surgically cut out and this procedure rarely results in a recurrence.
• Steroids injections: This treatment helps to shrink the lipoma. In all practicality the procedure does not remove the tumor completely.

A lipoma need to not be removed because they do not become cancerous. But they are recommended to be surgically removed in the following cases –
• If they become tender and sore
• If they get infected often
• If they release foul smelling liquid
• Becomes a cosmetic deterrent
• Interferes with function or movement.

Lipoma pictures