Lipomas are the commonest benign subcutaneous tumors having incidence of 1 to 2 persons per thousand populations. They are generally painless and varies in size from few millimetre to 5 centimetre in diameter. Often multiple but may be solitary also. It has hereditary link and therefore may be found in some other family member also.
What causes Lipoma
Lipomas are associated with chromosome 12Q15, 12Q13 & 12Q14 of gene HMGIC. It is an autosomal dominant disorder. Development of Lipoma may be precipitated by some minor trauma. But some believe that this may be incidental only.
It has no relation to obesity and dyslipidemia.
Consistency –rubbery, non-tender, movable, non-fluctuating. Remains steady in size or grow very slowly in years. It is composed of fat tissue surrounded by a capsule.
Character – Do not regress automatically or change to malignancy.
Location – Less on head and shoulder, but may be found anywhere in body. They are situated in the subcutaneous tissue.
Common locations are trunk, neck, upper thigh, upper arm and armpit. Mostly multiple in number.
Size- In 80 percent cases variable from 4 mm to 5 cm in diameter, and rarely up to 20 cm and weighing above a kilogram.
Age – commonly noticed from 3rd decade of life and may be seen even in the age of sixty.
Sex – males are found more prone, nearly double to the number of females.
Other similar conditions to Lipomatosis (condition in which multiple lipomas are present on the body) are – Dercum disease – multiple painful lipomas having swelling, and fatigue, mostly seen on obese premenopausal ladies. Madelung disease – rare, multiple, symmetrical lipomatosis on neck and upper extremity. Mostly seen in alcoholic persons.
Easy to diagnose by observation and palpation. Sometimes MRI, ultrasonography or x- rays are done in deeply situated cases. Intensive investigations may be needed when there may be any possibility of Liposarcoma.
Needs removal on cosmetic ground if a Lipoma is situated in a visible part of body and person gets embarrassment. Sometimes may result in pain due to nerve compression. In that case also doctor suggests for excision. Otherwise for small asymptomatic lipomas no treatment is needed.
Lipoma removal may be done using a local anaesthesia. Subsequently biopsy is done routinely to rule out any malignancy.
Liposuction and Lipolysis by injecting phosphatidyl chlorine are other treatment modalities.