Lipoma is also known as Dercum’s disease, which is a benign tumor composed of fatty tissue growth, characterized by a soft, movable, and painless mass beneath the skin, but sometimes it can be found deeper within the body. Lipomas are typically smaller than 5cm in diameter, they develop commonly on the upper extremities such as the back, shoulders, and abdomen and multiple occur simultaneously. Digital lipomas are rare, whereas digital lipomas are more common in women and tend to affect lower limbs frequently. These fatty growths are enclosed in capsules and consist of adipose tissue with slightly enlarged cells. For lipomas, causes are generally unclear but there are factors which include obesity, lack of exercise, and family history. Diagnosis for lipomas is based on physical examination or tissue biopsy/medical imaging is used to confirm. Lipomas are generally not associated with cancer risk and are prevalent in roughly 2%, of the population predominantly affecting adults aged 40 to 60 years, with slightly higher incidence in males. The reoccurrence rate of lipoma is very low after treatment.

What are the different types of Lipomas based on size or location?

Generally, lipomas are harmless, they can vary in size, location, and characteristics. Here are some different types of lipomas:

  • Angiolipoma: It contains both fatty and blood vessels, they may be painful or tender to touch. These types of lipomas are often found on the upper trunk, arms, or neck.
  • Hibernoma: These are rare kinds of lipomas resembling brown fat tissue, usually found on the neck, shoulders, or back, and may cause pain or discomfort.
  • Spindle Cell Lipoma: It contains spindle-shaped cells, usually found on the neck, shoulders, or back. These types of lipomas are usually slow-growing and painless.
  • Pleomorphic Lipoma: It is characterized as a mix of fat cells, spindle cells, or multinucleated giant cells, often found around the neck.
  • Deep Intramuscular Lipoma: It occurs within the muscle tissue, beneath the skin, usually feels firmer than subcutaneous lipomas, and can be more challenging to remove through surgical procedures due to their location.
  • Superficial Subcutaneous Lipomas: It is the most common type of lipoma, located beneath the skin, and usually feels soft and movable when touched.
  • Intestinal Lipoma: It develops in the intestines, and usually may not cause any symptoms unless they grow larger enough to cause bowel obstructions or other gastrointestinal issues.
  • Intradermal Lipoma: It occurs within the layers of the skin and is small, usually found on the neck, head, or shoulders.

What are the common symptoms of Lipoma?

Lipomas are shaped lump that are painless until they affect organs, nerves, blood vessels, or joints, here are some common signs & symptoms of lipoma:

  • Visible or palpable lump
  • Soft and Rubbery texture moved under the skin
  • No pain or discomfort
  • Gradual growth in size over time
  • Location-dependent symptoms such as pain, limited range of motion, numbness, and tingling

What are primary surgical and non-surgical treatment available for Lipoma?

  • Surgical Treatment for Lipoma

Surgical excision is considered the most effective method, for complete removal of the encapsulation which minimizes the risk of recurrence. For surgical excision, it is advisable to remove lipomas while they are smaller in size, to reduce the risk of complications such as interference with joints, nerves, or blood vessels, which could make the excision procedure more complex and invasive as they grow larger.

Depending on the location of the lipoma, different surgical approaches may be used lipomas in the subcutaneous tissue can removed with a small incision while Liposuction used to remove the fatty tissue of the lipoma, usually for larger lipomas which are in complex sites, where surgical excision may be challenging. Lipomas located in the gastrointestinal tract, colonoscopic or endoscopic techniques may be used for removal.

  • Non-surgical Treatment for Lipoma

In Lipoma various treatment techniques are used such as sodium deoxycholate (with or without phosphatidylcholine) injected directly into the growth, along with isoproterenol, removing the tumor through surgical removal or liposuction the only minimally invasive technique. These steroid injections are not as effective as surgical removal and may not permanent results for lipoma and multiple sessions of steroids are necessary to reduce the lump size. Non-surgical treatment also depends on the size and location of the lipoma.

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