Benign tumours composed of adipose tissue.
Can occur in any area of the body, although they are most frequently found on the trunk or proximal limbs. Most commonly found in subcutaneous tissues.
Rare sites include the gastrointestinal tract, adrenal glands, parotid glands, parapharyngeal space, breast, mediastinum, pleura, airways, heart, superior vena cava, brain, and intraspinal areas.
Cutaneous lipomas are usually soft, mobile, and superficial.
Lipomas have no malignant potential. However, the differential diagnosis includes liposarcomas, which are malignant, so this must always be carefully considered.
Surgical resection is indicated for symptomatic relief, pathological confirmation, or cosmetic reasons, or if there is an increase in size.
Lipomas are slow-growing, benign, mesenchymal tumours that form well-circumscribed, lobulated lesions composed of adipocytes. They are demarcated from surrounding fat by a thin, fibrous capsule. They comprise 50% of soft-tissue neoplasms and are commonly encountered by primary care physicians, surgeons, and pathologists. Lipomas usually arise in the subcutaneous tissues and may occur in any area of the body, although they most frequently occur on the trunk and proximal limbs. They have no malignant potential, but the differential diagnosis includes liposarcomas, which do have this potential, so this must always be considered.
History and exam
Key diagnostic factors
- presence of risk factors
- cutaneous mass <5 cm diameter
- soft cutaneous mass
- mobile cutaneous mass
- superficial cutaneous mass
Other diagnostic factors
- painless cutaneous mass
- gastrointestinal obstruction
- gastrointestinal bleeding
- abdominal mass
- muscle weakness
- genetic predisposition
- heavy alcohol consumption
Investigations to consider
- CT scan
- core needle biopsy
- incisional biopsy
- excisional biopsy
- upper gastrointestinal contrast study
superficial cutaneous lipoma on trunk or extremity
retroperitoneal lipomatous mass
symptomatic gastrointestinal lipoma
lipoma in atypical site
Kimberly Moore Dalal, MD
Medical Director, Surgical Oncology
Palo Alto Medical Foundation
KMD is an author of a number of references cited in this topic.
Steven D. DeMartini, MD
SDD declares that he has no competing interests.
Jason Gold, MD
VA Boston Healthcare System
Assistant Professor of Surgery
Harvard Medical School (Brigham and Women's Hospital)
JG declares that he has no competing interests.
Andrew D. Lee, MD
Department of Dermatology
Wake Forest University School of Medicine
ADL declares that he has no competing interests.
Chandrakanth Are, MD
Department of Surgery
University of Nebraska Medical Center
CA declares that he has no competing interests.
Clifford Cho, MD
Department of Surgery
Section of Surgical Oncology
University of Wisconsin School of Medicine and Public Health
CC declares that he has no competing interests.
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