Sections

Overview

Background

Lipomas are benign tumors composed of mature fat cells. They are the most common benign mesenchymal tumor. Lipomas are found in the subcutaneous tissues and, less commonly, in internal organs. Most cases are easy to diagnose and do not affect morbidity. Lipomas typically develop as discrete rubbery masses in the subcutaneous tissues of the trunk or proximal extremity. Lipomas are usually a few centimeters in size and can be removed by surgical excision or, less commonly, liposuction. Also see the Medscape Drugs & Diseases general surgery article, Lipomas.

Pathophysiology

Lipomas differ biochemically from normal fat by demonstrating increased levels of lipoprotein lipase and the presence of a large number of precursor cells.

Approximately 60% of solitary cutaneous lipomas display clonal alterations. The most common alteration involves a breakpoint on bands 12q13-15. Karyotype aberrations also have been noted on arms 6p and 13q. Multiple lipomas do not display these alterations.^[1]

Frequency

In one study of a Scandinavian population, 43% of benign mesenchymal tumors were lipomas. Overall, the incidence of a lipoma occurs in 1 in 1000 people.^[2]

Sex

Solitary lipomas are seen predominately in women. Multiple lipomas occur more frequently in men.

Age

Lipomas can occur at any age; however, they usually arise in early adulthood. Rarely, they can occur in childhood or infancy.^[3]

Prognosis

Cutaneous lipomas can cause mild tenderness, and angiolipomas are often tender. Lipomas are not associated with fatalities.

Clinical Presentation

Tallini G, Dal Cin P, Rhoden KJ, et al. Expression of HMGI-C and HMGI(Y) in ordinary lipoma and atypical lipomatous tumors: immunohistochemical reactivity correlates with karyotypic alterations. Am J Pathol. 1997 Jul. 151(1):37-43. [QxMD MEDLINE Link].
Rydholm A, Berg NO. Size, site and clinical incidence of lipoma. Factors in the differential diagnosis of lipoma and sarcoma. Acta Orthop Scand. 1983 Dec. 54 (6):929-34. [QxMD MEDLINE Link].
Billon R, Dainese L, Constantinescu G, Boudjemaa S, Chretien-Marquet B, Fasola S, et al. Primary cutaneous B-cell lymphoblastic lymphoma in children. Report of two cases. Pediatr Dermatol. 2015 Jan-Feb. 32 (1):e36-8. [QxMD MEDLINE Link].
Economides NG, Liddell HT. Benign symmetric lipomatosis (Madelung's disease). South Med J. 1986 Aug. 79(8):1023-5. [QxMD MEDLINE Link].
Gomes da Silva R, Detoffol Bragança R, Ribeiro Costa C, Torres de Melo L, Weiss Telles R, Costa Silva L. Multiple symmetric lipomatosis. J Cutan Med Surg. 2011 Jul-Aug. 15(4):230-5. [QxMD MEDLINE Link].
Ardeleanu V, Chicos S, Georgescu C, Tutunaru D. Multiple benign symmetric lipomatosis -- a differential diagnosis of obesity. Chirurgia (Bucur). 2013 Jul-Aug. 108(4):580-3. [QxMD MEDLINE Link].
Bonatus TJ, Alexander AH. Dercum's disease (adiposis dolorosa). A case report and review of the literature. Clin Orthop Relat Res. 1986 Apr. 251-3. [QxMD MEDLINE Link].
Brodovsky S, Westreich M, Leibowitz A, Schwartz Y. Adiposis dolorosa (Dercum's disease): 10-year follow-up. Ann Plast Surg. 1994 Dec. 33(6):664-8. [QxMD MEDLINE Link].
Hansson E, Svensson H, Stenram U, Brorson H. Histology of adipose tissue inflammation in Dercum's disease, obesity and normal weight controls: a case control study. J Inflamm (Lond). 2011 Sep 28. 8(1):24. [QxMD MEDLINE Link]. [Full Text].
Labuzek K, Liber S, Suchy D, Okopieå BA. A successful case of pain management using metformin in a patient with adiposis dolorosa. Int J Clin Pharmacol Ther. 2013 Jun. 51(6):517-24. [QxMD MEDLINE Link].
Miyakura T, Irisawa R, Miyamoto M, Iwaya K, Yamamoto T, Tsuboi R. An atypical case of atypical lipomatous tumor. Am J Dermatopathol. 2008 Dec. 30(6):590-2. [QxMD MEDLINE Link].
Sawamura S, Kajihara I, Jinnin M, Honda Y, Ihn H. Cutaneous spindle cell adenolipoma on the nose: A rare variant of lipoma. J Dermatol. 2017 Jul. 44 (7):e156-e157. [QxMD MEDLINE Link].
Katsuyama Y, Shirai T, Terauchi R, Tsuchida S, Mizoshiri N, Mori Y, et al. Chondroid lipoma of the neck: a case report. BMC Res Notes. 2018 Jun 28. 11 (1):415. [QxMD MEDLINE Link].
Kawaguchi M, Kato H, Tomita H, Hara A, Matsuo M. CT and MR imaging findings of solitary nevus lipomatosus cutaneous superficialis: radiological-pathological correlation. Skeletal Radiol. 2020 Jan. 49 (1):129-135. [QxMD MEDLINE Link].
Wolfe SW, Bansal M, Healey JH, Ghelman B. Computed tomographic evaluation of fatty neoplasms of the extremities. A clinical, radiographic, and histologic review of cases. Orthopedics. 1989 Oct. 12(10):1351-8. [QxMD MEDLINE Link].
Kuwano Y, Ishizaki K, Watanabe R, Nanko H. Efficacy of diagnostic ultrasonography of lipomas, epidermal cysts, and ganglions. Arch Dermatol. 2009 Jul. 145(7):761-4. [QxMD MEDLINE Link].
Sachdeva MP, Goldblum JR, Rubin BP, Billings SD. Low-fat and fat-free pleomorphic lipomas: a diagnostic challenge. Am J Dermatopathol. 2009 Jul. 31(5):423-6. [QxMD MEDLINE Link].
Juhlin L. Long-standing pain relief of adiposis dolorosa (Dercum's disease) after intravenous infusion of lidocaine. J Am Acad Dermatol. 1986 Aug. 15(2 Pt 2):383-5. [QxMD MEDLINE Link].
Reggiani M, Errani A, Staffa M, Schianchi S. Is EMLA effective in Dercum's disease?. Acta Derm Venereol. 1996 Mar. 76(2):170-1. [QxMD MEDLINE Link].
Gonciarz Z, Mazur W, Hartleb J, et al. Interferon alfa-2b induced long-term relief of pain in two patients with adiposis dolorosa and chronic hepatitis C. J Hepatol. 1997 Dec. 27(6):1141. [QxMD MEDLINE Link].
Matarasso A, Pfeifer TM. Mesotherapy for body contouring. Plast Reconstr Surg. 2005 Apr 15. 115(5):1420-4. [QxMD MEDLINE Link].
Rohrich RJ. Mesotherapy: what is it? Does it work?. Plast Reconstr Surg. 2005 Apr 15. 115(5):1425. [QxMD MEDLINE Link].
Rotunda AM, Ablon G, Kolodney MS. Lipomas treated with subcutaneous deoxycholate injections. J Am Acad Dermatol. 2005 Dec. 53(6):973-8. [QxMD MEDLINE Link].
Amber KT, Ovadia S, Camacho I. Injection therapy for the management of superficial subcutaneous lipomas. J Clin Aesthet Dermatol. 2014 Jun. 7 (6):46-8. [QxMD MEDLINE Link].
Mlosek RK, Malinowska S, Woźniak W. Lipoma removal using a high-frequency ultrasound-guided injection of a Class III CE-marked device-Empirical findings. J Cosmet Dermatol. 2018 Jul 19. [QxMD MEDLINE Link].
Couto RA, Mulliken JB, Padwa BL, Hassanein AH, Rogers GF, Kulungowski AM, et al. Facial infiltrating lipomatosis: expression of angiogenic and vasculogenic factors. J Craniofac Surg. 2011 Nov. 22(6):2405-8. [QxMD MEDLINE Link].
Bassetto F, Scarpa C, De Stefano F, Busetto L. Surgical treatment of multiple symmetric lipomatosis with ultrasound-assisted liposuction. Ann Plast Surg. 2014 Nov. 73(5):559-62. [QxMD MEDLINE Link].
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Berntorp E, Berntorp K, Brorson H, Frick K. Liposuction in Dercum's disease: impact on haemostatic factors associated with cardiovascular disease and insulin sensitivity. J Intern Med. 1998 Mar. 243(3):197-201. [QxMD MEDLINE Link].
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Media Gallery

A 43-year-old white man with a 3- to 4-year history of a slow-growing asymptomatic growth on his right shoulder.
A 43-year-old man with a slow-growing asymptomatic growth.
Surgical excision of a 6-cm lipoma on the back of a 54-year-old man using the squeeze technique.

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Author

Marjon Vatanchi, MD Board Certified Dermatologist, Board Certified Micrographic Dermatologic Surgeon

Marjon Vatanchi, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, Dermatologic Society of Greater New York, Medical Dermatology Society, National Psoriasis Foundation, New England Dermatological Society, Society for Pediatric Dermatology, Women's Dermatologic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Vineet Mishra, MD, FAAD Director of Mohs Surgery and Dermatologic Surgery, Assistant Professor of Dermatology, University of Texas Health Science Center at San Antonio

Vineet Mishra, MD, FAAD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American College of Phlebology, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD Herman Beerman Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Pennsylvania Academy of Dermatology

Disclosure: Received royalty from Lippincott Williams Wilkins for textbook editor.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD<br/>Served as a speaker for various universities, dermatology societies, and dermatology departments.

Additional Contributors

Janet Fairley, MD Professor and Head, Department of Dermatology, University of Iowa, Roy J and Lucille A Carver College of Medicine

Janet Fairley, MD is a member of the following medical societies: American Academy of Dermatology, American Federation for Medical Research, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Robert A Moraru, MD Staff Physician, Department of Dermatology, St Luke's/Roosevelt Hospital Center, Columbia Presbyterian Medical Center

Robert A Moraru, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Cutaneous Lipomas

Background

Pathophysiology

Epidemiology

Frequency

Sex

Age

Prognosis

Cutaneous Lipomas

Background

Pathophysiology

Epidemiology

Frequency

Sex

Age

Prognosis

References

Tables

Contributor Information and Disclosures

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