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Diseases

Lipoma

OVERVIEW

  • Highlights & Basics
  • Images

DIAGNOSIS

  • Diagnostic Approach
  • Risk Factors
  • History & Exam
  • Tests
  • Differential Diagnosis
  • Criteria
  • Screening

TREATMENT

  • Tx Approach
  • Tx Options
  • Emerging Tx
  • Prevention

FOLLOW-UP

  • Overview
  • Complications

REFERENCES

  • Citations
  • Guidelines
  • Credits

PATIENT RESOURCES

  • Patient Instructions

Highlights & Basics

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Key Highlights
  • Lipomas are benign tumors composed of adipose tissue.

  • They can occur in any area of the body, although they are most frequently found on the trunk or proximal limbs. They are most commonly found in subcutaneous tissues.

  • Lipomas may occur in deeper body cavities and within/adjacent to such organs as 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 of liposarcoma should be carefully considered.

Intramuscular lipoma, right thigh. MRI, axial, T1-weighted image. Lipomatous mass in the anterior as
Intramuscular lipoma, right thigh. MRI, axial, T1-weighted image. Lipomatous mass in the anterior aspect of the right thigh
From the collection of Dr Kimberly Moore Dalal and Dr Steven D. DeMartini; used with permission

Quick Reference

  • History & Exam

    • Key Factors

      • Other Factors

        More information...
      • Diagnostics Tests

          More information...
        • Treatment Options

            More information...

          Definition

          Epidemiology

          Etiology

          Pathophysiology

          content by BMJ Group
          Last updated

          Images

          • Subcutaneous lipoma on the trunk

            Subcutaneous lipoma on the trunk

          • Gastric submucosal lipoma, CT scan. Submucosal antral mass with fatty density throughout.

            Gastric submucosal lipoma, CT scan. Submucosal antral mass with fatty density throughout.

          • Gastric submucosal lipoma, upper GI contrast study. Filling defect in the distal antrum and pyloric

            Gastric submucosal lipoma, upper GI contrast study. Filling defect in the distal antrum and pyloric channel suggesting antral mass prolapsing into pyloric channel

          • Gastric submucosal lipoma. A nodule of mature adipose tissue is present subjacent to gastric mucosa.

            Gastric submucosal lipoma. A nodule of mature adipose tissue is present subjacent to gastric mucosa. Hematoxylin and eosin, 20x magnification

          • Angiolipoma. Mature adipose tissue with foci of endothelial proliferation containing microvascular t

            Angiolipoma. Mature adipose tissue with foci of endothelial proliferation containing microvascular thrombi. Hematoxylin and eosin, 200x magnification

          • Spindle cell lipoma. Mature adipose tissue with intervening strands of dense fibrosis with spindle c

            Spindle cell lipoma. Mature adipose tissue with intervening strands of dense fibrosis with spindle cell areas and characteristic ropey collagen bundles. Hematoxylin and eosin, 200x magnification

          • Intramuscular lipoma, right thigh. MRI, axial, T1-weighted image. Lipomatous mass in the anterior as

            Intramuscular lipoma, right thigh. MRI, axial, T1-weighted image. Lipomatous mass in the anterior aspect of the right thigh

          • Intramuscular lipoma, right thigh. MRI, coronal, T1-weighted image. Lipomatous mass in the anterior

            Intramuscular lipoma, right thigh. MRI, coronal, T1-weighted image. Lipomatous mass in the anterior aspect of the right thigh

          • Intramuscular lipoma of subscapularis muscle, CT scan. Right axillary soft-tissue fatty mass with we

            Intramuscular lipoma of subscapularis muscle, CT scan. Right axillary soft-tissue fatty mass with well-circumscribed margins

          • Intramuscular lipoma. Mature adipose tissue insinuating between skeletal muscle bundles. Hematoxylin

            Intramuscular lipoma. Mature adipose tissue insinuating between skeletal muscle bundles. Hematoxylin and eosin, 200x magnification

          Citations

            Key Articles

            • Primary Care Dermatology Society. Lipoma. Nov 2021 [internet publication].​[Full Text]

            • Noebauer-Huhmann IM, Weber MA, Lalam RK, et al. Soft tissue tumors in adults: ESSR-approved guidelines for diagnostic imaging. Semin Musculoskelet Radiol. 2015 Dec;19(5):475-82.[Abstract]

            Referenced Articles

            • 1. Bancroft LW, Kransdorf MJ, Peterson JJ, et al. Benign fatty tumors: classification, clinical course, imaging appearance, and treatment. Skeletal Radiol. 2006 Oct;35(10):719-33.[Abstract]

            • 2. Austin RM, Mack GR, Townsend CM, et al. Infiltrating (intramuscular) lipomas and angiolipomas. A clinicopathologic study of six cases. Arch Surg. 1980 Mar;115(3):281-4.[Abstract]

            • 3. Mentzel T, Calonje E, Fletcher CD. Lipoblastoma and lipoblastomatosis: a clinicopathological study of 14 cases. Histopathology. 1993 Dec;23(6):527-33.[Abstract]

            • 4. Ahn C, Harvey JC. Mediastinal hibernoma, a rare tumor. Ann Thorac Surg. 1990 Nov;50(5):828-30.[Abstract][Full Text]

            • 5. Salam GA. Lipoma excision. Am Fam Physician. 2002 Mar 1;65(5):901-4.[Abstract][Full Text]

            • 6. Lellouch-Tubiana A, Zerah M, Catala M, et al. Congenital intraspinal lipomas: histological analysis of 234 cases and review of the literature. Pediatr Dev Pathol. 1999 Jul-Aug;2(4):346-52.[Abstract]

            • 7. Taylor AJ, Stewart ET, Dodds WJ. Gastrointestinal lipomas: a radiologic and pathologic review. AJR Am J Roentgenol. 1990 Dec;155(6):1205-10.[Abstract][Full Text]

            • 8. Shu S, Wang J, Zheng C. From pathogenesis to treatment, a systemic review of cardiac lipoma. J Cardiothorac Surg. 2021 Jan 6;16(1):1.[Abstract][Full Text]

            • 9. Leffell DJ, Braverman IM. Familial multiple lipomatosis. Report of a case and a review of the literature. J Am Acad Dermatol. 1986 Aug;15(2 pt 1):275-9.[Abstract]

            • 10. Toy BR. Familial multiple lipomatosis. Dermatol Online J. 2003 Oct;9(4):9.[Abstract]

            • 11. Enzi G. Multiple symmetric lipomatosis: an updated clinical report. Medicine (Baltimore). 1984 Jan;63(1):56-64.[Abstract]

            • 12. Hansson E, Svensson H, Brorson H. Review of Dercum's disease and proposal of diagnostic criteria, diagnostic methods, classification and management. Orphanet J Rare Dis. 2012 Apr 30;7:23.[Abstract][Full Text]

            • 13. Maximiano LF, Gaspar MT, Nakahira ES. Madelung disease (multiple symmetric lipomatosis). Autops Case Rep. 2018 Jul-Sep;8(3):e2018030.[Abstract][Full Text]

            • 14. Wortham NC, Tomlinson IP. Dercum's disease. Skinmed. 2005 May-Jun;4(3):157-62; quiz 163-4.[Abstract]

            • 15. Primary Care Dermatology Society. Lipoma. Nov 2021 [internet publication].​[Full Text]

            • 16. Dalal KM, Antonescu CR, Singer S. Diagnosis and management of lipomatous tumors. J Surg Oncol. 2008 Mar 15;97(4):298-313.[Abstract]

            • 17. Fanburg-Smith JC, Devaney KO, Miettinen M, et al. Multiple spindle cell lipomas: a report of 7 familial and 11 nonfamilial cases. Am J Surg Pathol. 1998 Jan;22(1):40-8.[Abstract]

            • 18. Brody HJ, Meltzer HD, Someren A. Spindle cell lipoma. An unusual dermatologic presentation. Arch Dermatol. 1978 Jul;114(7):1065-6.[Abstract]

            • 19. Kooby DA, Antonescu CR, Brennan MF, et al. Atypical lipomatous tumor/well-differentiated liposarcoma of the extremity and trunk wall: importance of histological subtype with treatment recommendations. Ann Surg Oncol. 2004 Jan;11(1):78-84.[Abstract]

            • 20. Al-Ani Z, Fernando M, Wilkinson V, et al. The management of deep-seated, lowgrade lipomatous lesions. Br J Radiol. 2018 Jun;91(1086):20170725.[Abstract][Full Text]

            • 21. Zuber TJ. Skin biopsy, excision, and repair techniques. In: Soft tissue surgery for the family physician. Kansas City, MO: American Academy of Family Physicians; 1998:100-6.​​

            • 22. Arlotta P, Tai AK, Manfioletti G, et al. Transgenic mice expressing a truncated form of the high mobility group I-C protein develop adiposity and an abnormally high prevalence of lipomas. J Biol Chem. 2000 May 12;275(19):14394-400.[Abstract][Full Text]

            • 23. Uhlin SR. Benign symmetric lipomatosis. Arch Dermatol. 1979 Jan;115(1):94-5.[Abstract]

            • 24. Erkek E, Hizel S, Sanlý C, et al. Clinical and histopathological findings in Bannayan-Riley-Ruvalcaba syndrome. J Am Acad Dermatol. 2005 Oct;53(4):639-43.[Abstract]

            • 25. Costa T, Fitch N, Azouz EM. Proteus syndrome: report of two cases with pelvic lipomatosis. Pediatrics. 1985 Dec;76(6):984-9.[Abstract]

            • 26. Vidal A, Iglesias MJ, Fernández B, et al. Cutaneous lesions associated to multiple endocrine neoplasia syndrome type 1. J Eur Acad Dermatol Venereol. 2008 Jul;22(7):835-8.[Abstract]

            • 27. Signorini M, Campiglio GL. Posttraumatic lipomas: where do they really come from? Plast Reconstr Surg. 1998 Mar;101(3):699-705.[Abstract]

            • 28. Aust MC, Spies M, Kall S, et al. Posttraumatic lipoma: fact or fiction? Skinmed. 2007 Nov-Dec;6(6):266-70.[Abstract]

            • 29. Jacobson BC, Bhatt A, Greer KB, et al. ACG clinical guideline: diagnosis and management of gastrointestinal subepithelial lesions. Am J Gastroenterol. 2023 Jan 1;118(1):46-58.[Abstract][Full Text]

            • 30. Zhang H, Erickson-Johnson M, Wang X, et al. Molecular testing for lipomatous tumors: critical analysis and test recommendations based on the analysis of 405 extremity-based tumors. Am J Surg Pathol. 2010 Sep;34(9):1304-11.[Abstract]

            • 31. ​American College of Radiology. ACR appropriateness criteria: soft-tissue masses. 2022 [internet publication].[Full Text]

            • 32. Noebauer-Huhmann IM, Weber MA, Lalam RK, et al. Soft tissue tumors in adults: ESSR-approved guidelines for diagnostic imaging. Semin Musculoskelet Radiol. 2015 Dec;19(5):475-82.[Abstract]

            • 33. Rahmani G, McCarthy P, Bergin D. The diagnostic accuracy of ultrasonography for soft tissue lipomas: a systematic review. Acta Radiol Open. 2017 Jun 30;6(6):2058460117716704.[Abstract]

            • 34. ​National Institute for Health and Care Excellence. Suspected cancer: recognition and referral. Oct 2023 [internet publication].[Full Text]

            • 35. Varma DG. Optimal radiologic imaging of soft tissue sarcomas. Semin Surg Oncol. 1999 Jul-Aug;17(1):2-10.[Abstract]

            • 36. Demas BE, Heelan RT, Lane J, et al. Soft-tissue sarcomas of the extremities: comparison of MR and CT in determining the extent of disease. AJR Am J Roentgenol. 1988 Mar;150(3):615-20.[Abstract][Full Text]

            • 37. Gaskin CM, Helms CA. Lipomas, lipoma variants, and well-differentiated liposarcomas (atypical lipomas): results of MRI evaluations of 126 consecutive fatty masses. AJR Am J Roentgenol. 2004 Mar;182(3):733-9.[Abstract][Full Text]

            • 38. Thompson WM. Imaging and findings of lipomas of the gastrointestinal tract. AJR Am J Roentgenol. 2005 Apr;184(4):1163-71.[Abstract][Full Text]

            • 39. Heslin MJ, Lewis JJ, Woodruff JM, et al. Core needle biopsy for diagnosis of extremity soft tissue sarcoma. Ann Surg Oncol. 1997 Jul-Aug;4(5):425-31.[Abstract]

            • 40. Dalal KM, Antonescu CR, Singer S. Diagnosis and management of lipomatous tumors. J Surg Oncol. 2008 Mar 15;97(4):298-313.[Abstract]

            • 41. National Institute for Health and Care Excellence. Surgical site infections: prevention and treatment. Aug 2020 [internet publication].​[Full Text]

            • 42. Ostendorf W. Preparation for safe medication administration. In: Perry AG, Potter PA, Elkin MK, eds. Nursing interventions & clinical skills. 7th ed. St Louis, MO: Mosby; 2020.

            • 43. WHO Best Practices for Injections and Related Procedures Toolkit. Geneva: World Health Organization; 2010 Mar.[Abstract]

            • 44. Jin JF, Zhu LL, Chen M, et al. The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection. Patient Prefer Adherence. 2015;9:923-42.[Abstract][Full Text]

            • 45. Al-basti HA, El-Khatib HA. The use of suction-assisted surgical extraction of moderate and large lipomas: long-term follow-up. Aesthetic Plast Surg. 2002 Mar-Apr;26(2):114-7.[Abstract]

            • 46. Bechara FG, Sand M, Sand D, et al. Lipolysis of lipomas in patients with familial multiple lipomatosis: an ultrasonography-controlled trial. J Cutan Med Surg. 2006 Jul-Aug;10(4):155-9.[Abstract]

            • 47. Sharzehi K, Sethi A, Savides T. AGA clinical practice update on management of subepithelial lesions encountered during routine endoscopy: expert review. Clin Gastroenterol Hepatol. 2022 Nov;20(11):2435-43.e4.[Abstract][Full Text]

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