Fatty tumor or steatoma.
3.2.5 Lipoma
Synonyms
Epidemiology
Relatively frequent tumor. Lipomas occur in 1-2% of the adult population. Males > females.
Definition
Adipocytic tumors are benign soft tumors of the skin, arising from the subcutaneous fat tissue.
Aetiology & Pathogenesis
Most frequently spontaneous but there may be a genetic predisposition (see subtypes).
Signs & Symptoms
Rubbery feeling, Indolent (slowly growing), soft, mobile, circumscribed, round, subcutaneous mass.
Localisation
Lipoma may be solitary, multiple or disseminated, and may occur anywhere.
Classification
- Single or multiple (lipomatosis) non-pain associated lipomas
- Subtypes: familial multiple lipomatosis, adiposis dolorosa (Dercum disease), a condition marked painful lipomas. Familial multiple lipomatosis, a hereditary condition that causes multiple lipomas. Benign symmetric lipomatosis (Madelung disease), a rare condition marked by lipomas forming around the upper body.
Laboratory & other workups
No laboratory tests are needed. Ultrasound.
Dermatopathology
Well limited fatty tissue lobules, frequently with a connective tissue capsule. Lipomas with vessel proliferation: angiolipomas; lipomas with connective tissue proliferation: fibrolipomas and mixed types: angiofibrolipomas.
Course
The typical course is a slow growth followed by stabilization.
Complications
Pressure on adjacent tissues and vessel thrombosis within the lipoma may rarely lead to pain, esthetic discomfort.
Diagnosis
Clinical characteristic features, ultrasonography, and histological confirmation if needed.
Differential diagnosis
Malignant liposarcoma (well-differentiated liposarcoma (WDL) / atypical lipomatous tumor (ALT) must be suspected if the tumor is rapidly growing or painful, and in this case the lesion must be removed surgically for histopathological examination. Other differential diagnoses: cysts, connective tissue tumours, benign symmetrical lipomatosis.
Prevention & Therapy
Excision is performed in case of discomfort, or to rule out a malignant tumor if the clinical presentation is atypical (e.g. rapid growth, pain).
Podcasts
Tests
- Which of these clinical features apply to lipomas?
- How can a lipoma be diagnosed?
- If a lipoma is treated, then surgical excision is standard.
- Statement 1: Lipomas first undergo malignant change after years
- Statement 1: Lipomas are usually freely movable.
- Which of these clinical features apply to lipomas?
- How can a lipoma be diagnosed?
- If a lipoma is treated, then surgical excision is standard.
- Statement 1 Lipomas first undergo malignant change after years
- Statement 1 Lipomas are usually freely movable.
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