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Medical Disability Advisor  >  Lipoma

Lipoma

Related Terms

  • Adipoma
  • Adipose Tumor

Differential Diagnoses

Specialists

  • Dermatologist
  • General Surgeon
  • Internal Medicine Physician
  • Pathologist
  • Plastic Surgeon

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Factors Influencing Duration

Factors include the type and location of the lipoma and the specifics of its removal. The length of disability may be affected by job requirements, especially the ability to keep the surgical area clean postoperatively. For internal lipomas requiring major surgery, length of disability will depend on the extent of the surgery, whether complications develop, and whether the job is physically demanding.

Duration Trends from Reference Data

DURATION TRENDS
 ICD-9-CM: 214, 214.1, 214.8, 214.9  
CasesMeanMinMaxNo Lost TimeOver 6 Months
1153200790.1%0%
 
  
 
Percentile:5th25thMedian75th95th
Days:411172649
 
  
 

Differences may exist between the duration tables and the reference graphs. Duration tables provide expected recovery periods based on the type of work performed by the individual. The reference graphs reflect the actual experience of many individuals across the spectrum of physical conditions, in a variety of industries, and with varying levels of case management. Selected graphs combine multiple codes based on similar means and medians.

Medical Codes

ICD-9-CM:
214 - Lipoma
214.0 - Lipoma; Skin and Subcutaneous Tissue of Face
214.1 - Lipoma; Skin and Subcutaneous Tissue, Other
214.2 - Lipoma; Intrathoracic Organs
214.3 - Lipoma; Intra-abdominal Organs
214.4 - Lipoma; Spermatic Cord
214.8 - Lipoma; Specified Sites, Other
214.9 - Lipoma, Unspecified Site
M8850/0 - Lipoma

Definition

© Reed Group
A lipoma is a noncancerous (benign) tumor composed of fat cells (adipose tissue). Lipomas are usually small. They may remain the same size or may grow larger when an individual gains weight. They do not, however, generally decrease in size with weight loss. Lipomas do not usually cause any discomfort unless they are positioned in a way that presses on a nerve. An angiolipoma has blood vessels scattered through it. This type of lipoma can cause pain.

Lipomas may occur virtually anywhere there are fat cells, including the internal organs, but appear most often beneath the skin (subcutaneous lipoma) on the trunk, neck, back, thighs, and arms. They may occur singly or in groups. Certain disorders are characterized by multiple lipomas, including diffuse congenital lipomatosis, benign symmetric lipomatosis, Dercum's disease, and familial multiple lipomatosis. Although lipomas are found in all of these conditions, the characteristics of the conditions vary.

The tendency to develop lipomas is probably inherited but the way it is inherited is not known. The risk of developing lipomas is 30% greater in individuals with a family history of lipomas (Bancroft). The growth may also be triggered by a minor injury.

Risk: Lipomas usually occur in early adulthood in both sexes. Single lipomas are more common in women, while multiple lipomas are more common in men (Moraru).

Source: Medical Disability Advisor



History

History: Most individuals report a lump under the skin that may have been present for several years, increasing in size very gradually or growing larger if the individual gained weight. Pain may be reported depending upon the size and location of the tumor, but the majority of lipomas do not cause pain.

Physical exam: Most lipomas are dome-shaped and a few centimeters in diameter. They can be felt under the skin as a smooth, rubbery growth. The skin covering the lipoma is normal in appearance and can be moved back and forth over the nodule.

Tests: Usually no tests are required. If the individual's history or physical examination suggests the possibility of a malignant liposarcoma, microscopic examination of lipoma cells extracted via fine-needle aspiration (biopsy) is indicated. A CT scan or other imaging test may be performed to visualize the amount of fatty tissue and the muscles and blood vessels in the area around the lipoma.

Source: Medical Disability Advisor



Treatment

Lipomas generally require no treatment unless they are large, painful, in an inconvenient spot, and/or are unsightly. They may be removed by surgical excision or liposuction.

Source: Medical Disability Advisor



Prognosis

Recovery from removal of lipomas is generally uneventful and represents a cure. No fatalities have been reported with subcutaneous lipomas.

Source: Medical Disability Advisor



Complications

Lipomas under the skin (subcutaneous) rarely cause complications, but large nodules may interfere with muscle function. If they develop in the bowel, lipomas can cause potentially serious obstructions. Injury to a lipoma may require immediate treatment, including excision. Lipomas occurring on a joint may limit movement.

Source: Medical Disability Advisor



Return to Work (Restrictions / Accommodations)

For subcutaneous lipomas, few work restrictions or accommodations are required. If the job involves significant exposure to dirt, and if the individual has had the lipoma surgically removed, temporary reassignment may be necessary in order to keep the area clean postoperatively. Lipomas in or near internal organs may require major surgery for removal. This may necessitate a leave of absence for the employee, the length of which will be dependent upon the job requirements.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Does individual have a family history of lipomas?
  • Has individual recently gained weight?
  • Were conditions with similar symptoms, such as liposarcoma or other malignant tumor, and hibernomas ruled out?

Regarding treatment:

  • Was it necessary to remove the lipoma(s)?

Regarding prognosis:

  • Is individual obese?
  • Does individual consume alcohol or have a history of alcoholism?
  • Is individual on a weight reduction program?
  • Were the lipomas located in the bowel or other regions that necessitated major surgery?
  • Did individual have any complications?

Source: Medical Disability Advisor



Cited References

Bancroft, L. W., et al. "Soft Tissue Tumors of the Lower Extremities." Radiologic Clinics of North America 40 5 (2000): 991-1011.

Moraru, Robert A. "Lipomas." eMedicine. Eds. Janet Fairley, et al. 7 Nov. 2001. Medscape. 6 Jan. 2005 <http://emedicine.com/derm/topic242.htm>.

Source: Medical Disability Advisor






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