What is a lipoma and what types are there?
Lipoma consists of the same fat cells as subcutaneous tissue, but grows separately, is delimited by a capsule and divided into lobules. Usually it is located directly under the skin, but intermuscular and intramuscular lipomas, as well as lipomas of internal organs, can be found. Some varieties contain many vessels and can be painful. Some people develop multiple lipomas, sometimes in several family members. The size varies from a few millimeters to 10 cm or more.
- Subcutaneous - the most common
- Intermuscular and intramuscular
- Angiolipoma - painful, with blood vessels
- Fibrolipoma - denser
- Multiple familial lipomatosis
- Lipomas of internal organs
Causes and risk factors
Why lipoma appears is not completely known. Genetic changes are found in the cells of many lipomas, and multiple lipomas are often found in relatives. The role of soft tissue injuries is discussed. Lipomas are more often detected in middle-aged people. Contrary to popular belief, a wen is not associated with sludge or poor nutrition, and losing weight does not reduce its size. Alcohol abuse is associated with a rare form - symmetrical lipomatosis of the neck and shoulders.
- Hereditary predisposition
- Middle age
- Soft tissue injuries
- Some genetic syndromes
- Alcohol abuse - with symmetrical lipomatosis
Symptoms
A typical lipoma is a soft or doughy, round-shaped node that easily moves under the skin and is not fused to it. The skin over it is of normal color, without redness and a dot in the center. Pain is usually absent, but may appear when the nerve is compressed, located in a friction zone, or with angiolipoma. Large lipomas on the neck and back create a visible cosmetic defect, and on the extremities they can interfere with movements.
- A soft, moving knot under the skin
- Painless
- Slow growth
- Unchanged skin over the lesion
- Discomfort due to pressure from clothing
- Nerve compression pain
Diagnostics
The surgeon or dermatologist evaluates the formation during examination. To clarify the diagnosis, an ultrasound of soft tissues is performed: the study shows the structure, size, boundaries and depth of the node and helps to distinguish a lipoma from a cyst, lymph node, or hernia. If the tumor is larger than 5 cm, located deep, growing rapidly or looks atypical, an MRI and consultation with an oncologist are prescribed to rule out liposarcoma. After removal, the tissue is sent for histological examination.
- Examination by a surgeon
- Ultrasound of soft tissues
- MRI of soft tissues for large or deep tumors
- Biopsy for suspected malignancy
- Histology of distant formation
Treatment
Small lipomas that do not grow and do not bother you can be observed. Removal is recommended for growth, pain, tissue compression, cosmetic discomfort, injury from clothing and doubts about the diagnosis. The standard method is excision of the tumor along with the capsule under local anesthesia; large and deep lipomas are removed in the hospital. After complete removal, a lipoma rarely returns to its original location. Ointments, compresses and injections at home do not resolve the wen.
- Show the new education to the doctor
- Monitor the size of a small lipoma
- Remove if there is growth or discomfort
- Do not try to open or squeeze out the wen.
- Send the removed tissue for histology
