Lipomas

Definition:
A lipoma is a slow-growing, fatty lump that’s most often situated between your skin and the underlying muscle layer. Often a lipoma is easy to identify because it moves readily with slight finger pressure. It’s doughy to touch and usually not tender

 

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A lipoma is a benign tumor composed of adipose tissue. It is the most common form of soft tissue tumor. Lipomas are soft to the touch, usually movable, and are generally painless. Many lipomas are small (under one centimeter diameter) but can enlarge to sizes greater than six centimeters. Lipomas are commonly found in adults from 40 to 60 years of age, but can also be found in children. Some sources claim that malignant transformation can occur, while others say that this has yet to be convincingly documented
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Symptoms & Types:
There are several subtypes of lipoma:

*Angiolipoleiomyoma is an acquired, solitary, asymptomatic acral nodule, characterized histologically by well-circumscribed subcutaneous tumors composed of smooth muscle cells, blood vessels, connective tissue, and fat.

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*Angiolipoma is a painful subcutaneous nodule, having all other features of a typical lipoma.
Chondroid lipomas are deep-seated, firm, yellow tumors that characteristically occur on the legs of women.

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*Corpus callosum lipoma is a rare congenital condition which may or may not present with symptoms. Lipomas are usually relatively small with diameters of about 1–3 cm, but in rare cases they can grow over several years into “giant lipomas” that are 10–20 cm across and weigh up to 4–5 kg.

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*Hibernoma is a lipoma of brown fat.

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*Intradermal spindle cell lipoma is distinct in that it most commonly affects women, and has a wide distribution, occurring with relatively equal frequency on the head and neck, trunk, and upper and lower extremities….click & see

*Neural fibrolipoma is an overgrowth of fibro-fatty tissue along a nerve trunk that often leads to nerve compression.click & see

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*Pleomorphic lipomas, like spindle-cell lipomas, occur for the most part on the backs and necks of elderly men, and are characterized by floret giant cells with overlapping nuclei...click & see

*Spindle-cell lipoma is an asymptomatic, slow-growing subcutaneous tumor that has a predilection for the posterior back, neck, and shoulders of older men…..click & see

*Superficial subcutaneous lipoma, the most common type of lipoma, lies just below the surface of the skin. Most occur on the trunk, thighs and the forearms, although they may be found anywhere in the body where fat is located….click & see
Causes:
The exact cause of lipomas is unknown. Lipomas tend to run in families, so genetic factors likely play a role in their development.But the tendency to develop a lipoma is not necessarily hereditary although hereditary conditions, such as familial multiple lipomatosis, may include lipoma development. Genetic studies in mice from the laboratory of Santa J. Ono have shown a correlation between the HMG I-C gene (previously identified as a gene related to obesity) and lipoma development. These studies support prior epidemiologic data in humans showing a correlation between HMG I-C and mesenchymal tumors.

Cases have been reported where minor injuries are alleged to have triggered the growth of a lipoma, called “post-traumatic lipomas.” However, the link between trauma and the development of lipomas is controversial.
Diagnosis:
The diagnosis for lipoma is a simple physical examination by a health care provider. Because lipoma resembles another tumor which is cancerous, liposarcoma, a doctor may perform a biopsy of the tumor.(A tissue sample removal (biopsy) for lab examination).

An ultrasound or other imaging test, such as an MRI or CT scan,may be required  if the lipoma is large, has unusual features or appears to be deeper than the fatty tissue.

Liposarcomas — cancerous tumors in fatty tissues — grow rapidly, don’t move under the skin and are usually painful. A biopsy, MRI or CT scan is typically done if your doctor suspects liposarcoma.

Treatment:
Usually, treatment of a lipoma is not necessary, unless the tumor becomes painful or restricts movement. They are usually removed for cosmetic reasons, if they grow very large, or for histopathology to check that they are not a more dangerous type of tumor such as a liposarcoma.

Lipomas are normally removed by simple excision. The removal can often be done under local anaesthetic, and take less than 30 minutes. This cures the majority of cases, with about 1-2% of lipomas recurring after excision. Liposuction is another option if the lipoma is soft and has a small connective tissue component. Liposuction typically results in less scarring; however, with large lipomas it may fail to remove the entire tumor, which can lead to re-growth.

There are new methods being developed that are supposed to remove the lipomas without scarring. One of them is removal by the use of injection of compounds that trigger lipolysis, such as steroids or phosphatidylcholine.

Prognosis:
Lipomas are rarely life-threatening and the common subcutaneous lipomas are not a serious condition. Lipomas growing in internal organs can be more dangerous, for example lipomas in the gastrointestinal tract can cause bleeding, ulceration and painful obstructions. Malignant transformation of lipomas into liposarcomas is very rare and most liposarcomas are not produced from pre-existing benign lesions, although a few cases of malignant transformation have been described for bone and kidney lipomas. It is possible these few reported cases were well-differentiated liposarcomas in which the subtle malignant characteristics were missed when the tumour was first examined. Deep lipomas have a greater tendency to recur than superficial lipomas, because complete surgical removal of deep lipomas is not always possible

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://en.wikipedia.org/wiki/Lipoma
http://www.mayoclinic.com/health/lipoma/DS00634
http://www.nlm.nih.gov/medlineplus/ency/imagepages/1209.htm
http://www.helium.com/items/1297816-lipoma-diagnosis-and-treatment
http://www.mdguidelines.com/lipoma
http://www.kmle.co.kr/search.php?Search=angiolipoleiomyoma
http://www.cholinergicurticaria.net/2008/10/13/could-angiolipomas-or-tumors-cause-cholinergic-urticaria/
http://www.med.uc.edu/neurorad/webpage/eua.html
http://www.lookfordiagnosis.com/mesh_info.php?term=Lipoma&lang=1
http://radiographics.rsna.org/content/19/5/1253.full
http://www.medscape.com/content/2001/00/40/56/405672/art-nf1001.01.fig1.jpg

 

 

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