Lipomas, an overview

By Cristiano Antonino On May 28, 2023

Lipomas are a form of benign tumour that affects adipose tissue and is very common. It is caused by an overgrowth of lipid cells surrounded by fibrous capsules

Lipoma can affect any part of the body and occurs more frequently in men

It has a higher incidence in individuals over the age of fifty and, according to some studies, about 1% of the population has been affected at least once by a form of lipoma.

Lipomas: what are they?

Lipomas are very common benign tumours and take the form of clearly visible and palpable subcutaneous reliefs.

They are accumulations of fat cells surrounded by a capsule of fibrous tissue.

They appear soft to the touch and move when subjected to pressure.

They are not painful and can remain where they form for several years without causing any discomfort.

Lipomas can appear all over the body, but form most frequently in the shoulder, neck, abdomen, arms, back and thigh areas.

They usually affect the subcutaneous adipose tissue, but can also form in certain organs such as the intestines or kidneys.

Normally, lipomas reach a maximum size of 15 centimetres, but in rare cases they can continue to grow, reaching a weight of up to 5 kilos.

Lipomas: types and classes

There are different types of lipomas.

The ‘simplest’ one is white fat, then there is the glandular lipoma, a benign tumour that affects the neck and armpits, involving brown fat.

Angiolipoma forms at the adipose tissue and blood vessels, while angioleiomyolipoma is a subcutaneous tumour formed by smooth muscle cells, lipid and connective tissue and blood vessels.

The term myelolipoma refers to a formation consisting of adipose and haemopoietic tissue, whereas racemose lipoma is not ‘encapsulated’, i.e. surrounded by a capsule.

Over time, experts have made other distinctions related to where in the body lipomas develop

The most common form here is the superficial subcutaneous lipoma, which is created just below the surface of the epidermis.

It originates in any area of the body where fat is present, with a greater incidence on the trunk, arms and thighs.

We then find palmar lipoma, which affects the hand, and intestinal lipoma, which can cause bleeding.

When the formation is located near the heart, we speak of cardiac lipoma.

This condition, even though it is a benign tumour, can be very dangerous.

If the size increases, there is a risk that the formation may prevent the heart valves from functioning.

Meningeal lipomas are similarly dangerous.

Located in the meningeal sheaths, they can cause severe neuronal damage.

Doctors have also identified sacral lipomas, located in the sacral area, and intramural lipomas, which affect the colon.

Causes

To date, the causes leading to the formation of lipomas are still not completely clear.

According to some studies, there is a genetic predisposition; for other researchers, the lipoma originates from a major trauma.

Other theories link this pathology to an alteration in obesity genes.

Much research is currently underway to clarify the aetiology of lipomas.

In any case, there are certain risk factors that, according to statistics and doctors’ experience, predispose more to the appearance of lipomas.

These benign tumours are more common among men between the ages of 40 and 60.

They are very rare in children and adolescents.

Those most affected have a family history of the disease, suffer from obesity, diabetes or hypercholesterolaemia.

Most of the time, lipomas are clearly visible to the naked eye

They appear as mobile subcutaneous reliefs to the touch and with a soft consistency.

They usually cause no obvious symptoms, sometimes they can remain invisible and unchanged for years.

They cause concern depending on the area in which they form and their size.

In fact, in some cases, such as in the case of meningeal or cardiac lipomas, they can put the patient’s health at risk.

Lipomas are not painful.

This specific symptom can be felt when the formation grows, compressing nerve endings.

In rare cases, the lipoma may become painful if it turns into a malignant tumour.

However, as mentioned, this is an infrequent occurrence.

Possible complications

Lipomas are benign tumours, but in very rare cases they can undergo a mutation, becoming malignant.

In this case we speak of a liposarcoma.

They can affect any part of the body and must be detected promptly in order to act promptly.

Even if this is a remote possibility, it is always best to keep an eye on lipomas to assess their evolution and, if necessary, to consult a specialist.

Changes or alterations in the characteristics could in fact constitute an important alarm bell that should not be underestimated.

There are certain elements that must be taken into account and that should prompt the patient to seek medical advice immediately.

The lipoma should be checked immediately if it becomes a hard mass or causes pain, if it increases in volume rapidly, if it undergoes changes of any kind or grows back even after being removed.

Lipoma can be diagnosed after a simple medical examination

The doctor will perform a visual examination and, after assessing the patient’s symptoms, may prescribe further tests.

To ascertain the nature of the subcutaneous formation, a biopsy or instrumental analyses such as CT or MRI may sometimes be required.

Lipomas: treatment

Lipomas usually present no symptoms, which is why they should be monitored without any specific treatment.

Most often these benign tumour formations regress on their own.

Removal is performed when they create an aesthetic problem or impair the patient’s quality of life.

If the size of the lipoma increases, it may become inflamed, painful and hinder movement.

In these cases, the doctor will advise the patient on the best way to solve the problem.

The most common solution is surgical removal, which is performed under local anaesthesia.

In the case of lipomas located in deep tissue or with a large diameter, general anaesthesia may be necessary.

The surgeon incises the area, extracting the encapsulated lipoma.

The area is then closed with stitches and a clearly visible scar may often remain.

Another method for removing lipomas is liposuction, in which the formation is removed using a suction device.

Infiltration of corticosteroid drugs into the lesion is also prescribed to reduce the size.

After elimination, especially if the capsule remains in place, lipomas may reform in some cases; in such cases, total excision is usually required.

Lipomas: how to prevent them?

The causes of lipomas are still a mystery to medical science, which to date has not yet managed to understand what lies behind these formations.

However, this does not exclude the fact that there are certain factors that may favour their appearance.

A healthy lifestyle in fact has a key influence on health and on the occurrence not only of tumours, but of all diseases.

Following a few rules can help patients prevent the occurrence of lipomas.

First of all, it is essential not to smoke and to follow a healthy diet, consuming fibre, fruit and vegetables, but also limiting the intake of animal fats and alcohol.

Lipomatosis

Lipomatosis is a condition characterised by the appearance of multiple or single lipomas in the fatty areas of the body.

Also called lipodystrophy, this disease has a course that can alter the physical appearance of the sufferer, changing the patient’s body image.

It is a problem of a purely aesthetic nature, but in some cases it can lead to serious consequences.

Lipomatosis leads to the formation of an uncontrolled number of lipomas that spread to various areas of the body.

Lipomas have a soft consistency, are formed from adipose tissue and are mobile to the touch.

Although benign tumours are asymptomatic, they should be kept under control.

They can cause more serious problems by infiltrating various tissues and also affecting deeper areas close to organs.

What makes lipomatosis dangerous is precisely its unpredictability and the impossibility of precisely circumscribing the phenomenon.

There are various types of lipomatosis: multiple symmetrical (type I or type II), pelvic, epidural, painful, abdominal, Krabbe’s, mesosomatic Roch-Leri, asymmetrical, of the anal and perianal hilum or of the pancreas.

In addition, mitochondrial congenital disorders confer a predisposition to the development of head lipomas.

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