Overview

A lipoma is a benign (non-cancerous) tumor composed of soft, fatty tissue. It typically forms just beneath the skin and feels soft, movable, and painless to the touch. Lipomas are the most common type of soft tissue tumor in adults and can occur anywhere on the body, though they are most frequently found on the neck, shoulders, back, abdomen, and thighs. They grow slowly and are usually harmless, though in rare cases they may become painful or require removal for cosmetic reasons or due to discomfort.

Causes

The exact cause of lipomas is not fully understood, but several factors are thought to play a role in their development:

• Genetic predisposition: Lipomas often run in families, suggesting a hereditary link.
• Age: Lipomas are most commonly found in middle-aged adults, typically between 40 and 60 years old.
• Minor injuries: Some lipomas appear after trauma or injury to an area, though this link is not clearly established.
• Medical conditions: Rare genetic disorders like familial multiple lipomatosis, Gardner’s syndrome, and Madelung’s disease are associated with multiple lipomas.

Symptoms

Most lipomas are asymptomatic, but depending on size and location, they may cause certain signs and sensations:

• Soft, movable lump: The lump is usually soft, easily movable under the skin, and not attached to underlying tissues.
• Slow growth: Lipomas grow gradually over months or years and typically remain under 5 cm in diameter, though some can grow larger.
• Painless: Most lipomas are painless; however, they can cause discomfort if they compress nearby nerves or tissues.
• Multiple lipomas: Some individuals may develop more than one lipoma, especially in familial cases.
• Uncommon locations: Occasionally, lipomas may develop deeper within the body, though these are less common and may not be easily felt.

Diagnosis

Diagnosing a lipoma typically involves a clinical evaluation and, if necessary, imaging tests to confirm its nature:

• Physical examination: Doctors diagnose lipomas based on their characteristic feel and appearance.
• Medical history: Information about the lump's growth rate, tenderness, and any family history of lipomas is assessed.
• Imaging tests: Ultrasound, MRI, or CT scans may be used if the diagnosis is uncertain or if the lump is large or located in a deeper area.
• Biopsy: In rare cases, a tissue sample may be taken to rule out liposarcoma, a very rare cancerous tumor of fat cells.

Treatment

Most lipomas do not require treatment unless they cause discomfort, restrict movement, or are cosmetically concerning:

• Observation: Small, painless lipomas that are not growing can simply be monitored over time without treatment.
• Surgical removal: Excision is the most common treatment, performed under local anesthesia in an outpatient setting. It completely removes the lipoma and prevents recurrence in the same spot.
• Liposuction: In some cases, especially with larger lipomas, liposuction may be used to remove fatty tissue through a small incision, though there is a higher chance of recurrence.
• Minimal incision extraction: A less invasive technique where the lipoma is removed through a smaller cut, often used for cosmetic purposes.

Prognosis

The prognosis for lipomas is excellent as they are benign tumors with no risk of spreading:

• Non-cancerous: Lipomas are harmless and do not turn cancerous under normal circumstances.
• Effective removal: Surgical excision is curative in nearly all cases, with low recurrence rates when fully removed.
• Minimal complications: Surgery is usually low-risk with minimal scarring, though large lipomas may result in bigger scars.
• Rare recurrence: Lipomas can recur in some individuals, especially those with genetic conditions causing multiple growths.
• Good quality of life: Most people with lipomas continue normal activities without any health impact.

Overall, lipomas are a common and benign condition with a very favorable outcome, especially when managed appropriately by a healthcare provider.