A person with a lipoma will typically feel a soft, oval-shaped lump just beneath the skin. Lipomas are usually painless unless they affect joints, organs, nerves, or blood vessels. In most cases, they do not cause other symptoms.

A person with a lipoma that occurs deeper under the skin may not be able to see or feel it. However, a deep lipoma may place pressure on internal organs or nerves and cause associated symptoms. For example, a person with a lipoma on or near the bowels may experience nausea, vomiting, and constipation.

Speculation exists regarding a potential link between trauma and subsequent lipoma formation. One theory suggests that trauma-related fat herniation through tissue planes creates so-called pseudolipomas. It has also been suggested that trauma-induced cytokine release triggers pre-adipocyte differentiation and maturation. To date, no definitive link between trauma and lipoma formation has been prospectively demonstrated.

While the exact etiology of lipomas remains uncertain, an association with gene rearrangements of chromosome 12 has been established in cases of solitary lipomas, as has an abnormality in the HMGA2-LPP fusion gene.

Some people inherit a faulty gene from their parents that can cause one or more lipomas. This is rare and is known as familial multiple lipomatosis.

Lipomas can occur more frequently in people with specific medical conditions, such as:

• Gardner syndrome, a condition that causes benign tumors to form
• Adiposis dolorosa, a condition marked by the growth of lipomas
• Familial multiple lipomatosis, a hereditary condition that causes multiple lipomas to form
• Madelung disease, a rare condition marked by lipomas forming around the upper body
• Cowden syndrome, which is characterized by benign tumors, skin tags, and large head size

A lipoma doesn’t usually need to be treated unless it bothers. Doctor will recommend scheduling periodic checkups to note if the tumor is growing or changing in any other way. Approach Considerations to lipomas removed for the following reasons:

• Cosmetic reasons
• To evaluate their histology, particularly when liposarcomas must be ruled out
• When they cause symptoms
• When they grow and become larger than 5 cm

Surgical Therapy

Complete surgical excision with the capsule is advocated to prevent local recurrence, whether the lipoma in question is subcutaneous or intracardiac in origin. These lesions may be lobulated, and it is essential that all lobules be removed.

Specific therapy depends on the location of the tumor.

Subcutaneous lipomas are removed for cosmetic reasons, and hence, a cosmetically pleasing incision should be used. The incision is usually placed directly over the mass and is oriented to lie in a line of skin tension.

Steroid injections also use to shrink the lipoma but not eliminate it.

Liposuctin is an alternative that allows removal of the lipoma through a very small incision, the location of which may be remote from the actual tumor.

Liposuction may be employed more often in small facial lipomas, because favorable aesthetic results have been obtained through strategically placed incisions. Liposuction is indicated for the treatment of medium-sized (4-10 cm) and large (>10 cm) lipomas; in small lipomas, no advantage has been reported, because these tumors can be extracted through small incisions.

Need to visit a doctor if notice changes in a lipoma or if more lumps appear. These changes might involve the lipoma:

• increasing in size or suddenly growing very quickly
• being painful
• becoming red or hot
• turning into a hard or immovable lump
• causing visible changes in the overlying skin

• ABC Of Dermatology
• Clinical Dermatology
• Roxburgh’s common skin diseases
• Andrew’s Diseases of the skin