Lipoma
Definition
Lipomas are a form of growth made up of fat cells. They
are benign (non-cancerous). The overgrowth of fat cells
creates a lump or swelling somewhere in the body.
Incidence/Age
Lipomas may occur at any age. Males and females are equally
affected. Lipomas are very common benign growths in adults.
Causes
The exact cause of lipoma is not known. Some people have
a genetic tendency to develop lipoma. People with this genetic
tendency tend to develop many lipomas, ten to twenty is
not uncommon. People with this genetic tendency can pass
this tendency on to their children.
Sign/Symptoms
Lipomas may occur anywhere in the body, most commonly in
the subcutaneous tissue (under the skin). They are rounded,
soft and mobile and dome shaped. They vary in size from
two to maybe ten centimetres long; rarely some grow even
larger. Common locations for lipoma are the trunk, thighs
and shoulders. They are most common on the inner aspect
of the arm. Most lipomas grow very slowly and are painless.
A lipoma typically appears as a painless soft swelling,
which raises the skin into a dome shaped lump. Occasionally
lipoma can be painful and multiple. Such lipoma may run
in families in a condition known as Dercum's disease.
Some rare forms of lipoma can be found around nerves (neuro-lipoma)
and may also be associated with blood vessels (angiomyolipoma).
Complications
The vast majority of lipomas have no complications. Such
lipomas form harmless subcutaneous lumps, which require
no treatment. Lipomas in Dercum's disease are painful in
some cases. Rarely lipomas may press upon important structures,
eg, nerves and therefore produce symptoms.
Tests
Most lipomas can be diagnosed by the clinical history and
their appearance on examination. CT and MRI scans may be
needed to diagnose more deeply placed lipoma.
Treatment/Surgical
Most lipomas are cosmetic problems only and, therefore,
require no treatment.
Those lipomata that are enlarging or painful or pressing
on adjacent structures may require removal surgically.
Most lipoma can be removed under local anaesthesia via a
small overlying skin incision. The lipoma is typically easy
to remove and, provided it is removed completely, removal
is curative.
Lipomata around the shoulder and upper back may intertwine
with the muscles in this area and removal can be more difficult.
Lipomata in these locations and lipoma within the body cavities
require general anaesthetic for their removal.
Removal by liposuction - Reports exist of lipoma being removed
by liposuction. This is an effective technique, but because
complete removal cannot be guaranteed there is a risk of
lipoma recurrence. Whilst most lipoma are straight forward
to diagnose; liposuction of a lesion which turns out not
to be a lipoma is a possibility.
Outcome
Most lipomata require no surgical treatment. The vast majority
of lipomata that are treated surgically can be done so under
local anaesthesia as an out-patient or daycase via a small
incision. Complete cure can be expected in most cases.
