Lipoma

What it is

A lipoma is the most common benign tumor of soft tissue: a buildup of fat cells surrounded by a thin capsule, forming a soft, mobile, usually painless lump under the skin. It grows slowly, over the years, and can be single or multiple. It appears most often between ages 40 and 60, on the back, shoulders, neck, arms and thighs. It does not turn into cancer, but lumps that grow quickly, harden, hurt or lie deep need to be assessed with ultrasound and, sometimes, biopsy, to rule out other lesions. Small, symptom-free lipomas can simply be monitored; removal is indicated when they are bothersome, painful, interfere with movement or raise diagnostic doubt.

Most common symptoms

• Soft, mobile lump under the skin
• Slow growth, over months or years
• Usually painless, though it may bother appearance or dressing
• Commonly located on the back, shoulders, neck, arms and thighs
• A single lump or several in different areas
• Pain or limited movement when it grows or presses on nerves

Causes and risk factors

• Benign proliferation of fat cells
• Genetic predisposition and family history
• Age between 40 and 60
• Local trauma, in some cases
• Syndromes with multiple lipomas, more rarely

How it is diagnosed

Diagnosis is clinical in most cases: on exam, the surgeon identifies a soft, mobile, well-defined, painless lump, and assesses its size, depth and how long it has been present. Ultrasound confirms the fatty nature of the lesion and distinguishes a lipoma from cysts and other lumps. When the lump is deep, large, growing quickly, hardening or painful, MRI and biopsy may be indicated to rule out less common lesions. Any tissue removed is sent for analysis.

How we treat it at Femi Saúde

Small, asymptomatic lipomas with a clear diagnosis can simply be monitored, with periodic reassessment. Removal is indicated when the lump is bothersome, painful, growing, limiting movement or raising diagnostic doubt. The general surgery team at Femi Saúde performs the removal in the office, under local anesthesia, through a small incision through which the lipoma is removed along with its capsule, to reduce the chance of recurrence; large or deep lipomas may require a hospital setting. The tissue is sent for pathological analysis when indicated. The plan is individualized, taking into account size, location and the patient's expectations regarding the scar.

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