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A lipoma is a noncancerous (benign) tumor composed of fat cells (adipose tissue). Lipomas are usually small. They may remain the same size or 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. A type of lipoma called angiolipoma has blood vessels scattered through it, which can cause pain.
Lipomas may occur virtually anywhere there are fat cells, including the internal organs (usually in the esophagus, stomach, or small intestine), but appear most often beneath the skin (subcutaneous lipoma) on the trunk, neck, back, upper thighs, armpits, and upper 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 these conditions, the characteristics of the conditions vary.
Risk: Lipomas are the most common noncancerous tumor found in adults. Lipomas usually occur between the ages of 40 and 60 in both sexes, although they can arise at any age. Single lipomas are more common in women, whereas multiple lipomas are more common in men (Moraru).
The tendency to develop lipomas is probably inherited, but the way it is inherited is not known (Nissl). Lipoma may also be triggered by a minor injury (trauma). |
Source: Medical Disability Advisor
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. On occasion, a lipoma may be painful if it rubs against a nearby nerve.
Physical exam: Most subcutaneous lipomas are dome-shaped and 2 to 10 centimeters in diameter. They can be felt under the skin as a smooth, mobile, 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. With irregularly-shaped or large lipomas (greater than 5 cm in diameter), CT scan or MRI may be performed to help differentiate a lipoma from a liposarcoma (Pandya).
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Source: Medical Disability Advisor
Lipomas generally require no treatment unless they are large, painful, in an inconvenient spot, and/or are unsightly. To reduce their size, lipomas may be injected with steroids. They may also be removed by surgical excision or liposuction.
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Source: Medical Disability Advisor
Recovery from removal of lipomas is generally uneventful and represents a cure. No fatalities have been reported with subcutaneous lipomas. Steroid injection can shrink the size of a lipoma by as much as 75% (Pandya). After surgical excision, a subcutaneous lipoma may recur in 2% of cases; the recurrence rate for an intramuscular lipoma is 19% (Pandya).
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Source: Medical Disability Advisor
Lipomas under the skin (subcutaneous) rarely cause complications, but large nodules may interfere with muscle function or may cause nerve pain. Lipomas occurring on a joint may limit movement. If they develop in the bowel, lipomas can cause potentially serious obstructions. Injury to a lipoma may require immediate treatment, including excision. Rarely, a lump that initially appears to be a lipoma may actually be a liposarcoma (cancerous), requiring further treatment.
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Source: Medical Disability Advisor
For symptomatic 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 depend upon job requirements.
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Source: Medical Disability Advisor
| 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?
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Has individual recently gained weight?
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Does individual have single or multiple lipomas?
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Is lipoma causing pain? Bowel obstruction?
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Were conditions with similar symptoms, such as liposarcoma or other malignant tumor, and hibernomas ruled out?
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Is lipoma large or irregularly shaped?
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Is CT scan or MRI necessary?
Regarding treatment:
- Was it necessary to inject the lipoma(s) with steroids? Remove the lipoma(s) surgically?
Regarding prognosis:
- Is individual obese?
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Is individual on a weight-reduction program?
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Were the lipomas located in the bowel or other regions that necessitated major surgery?
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Did individual have any complications?
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Did lipoma recur?
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Source: Medical Disability Advisor
| CitedMoraru, Robert A. "Lipomas." eMedicine. Eds. Janet Fairley, et al. 8 May. 2008. Medscape. 26 Aug. 2009 <http://emedicine.medscape.com/article/1057855-overview>.Nickloes, Todd A., Daniel D. Sutphin, and Klaus Radebold. "Lipomas." eMedicine. Eds. Juan B. Ochoa, et al. 15 Jan. 2009. Medscape. 26 Aug. 2009 <http://emedicine.medscape.com/article/191233-overview>. Nissl, Jan. "Lipoma." WebMD. Eds. Susan van Houten, et al. 8 May. 2007. 26 Aug. 2009 <http://www.webmd.com/skin-problems-and-treatments/tc/lipoma-topic-overview>. Pandya, Kartik A., and Frederick Radke. "Benign Skin Lesions: Lipomas, Epidermal Inclusion Cysts, Muscle and Nerve Biopsies." Surgical Clinics of North America 89 3 (2009): 677-687. MD Consult. Elsevier, Inc. 26 Aug. 2009 <http://www.mdconsult.com/das/article/body/156451568-4/jorg=clinics&source=MI&sp=22173932&sid=880045999/N/699453/1.html?issn=0039-6109#S003961090900036X>. Shidham, Vinod B., et al. "Benign and Malignant Soft Tissue Tumors." eMedicine. Eds. Howard A. Chansky, et al. 30 Mar. 2009. Medscape. 26 Aug. 2009 <http://emedicine.medscape.com/article/1253816-overview>. |
Source: Medical Disability Advisor
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