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 of lipoma

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 of lipoma

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 removal of lipoma

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.

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