Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • Lipomas are slow growing, benign adipose tumors, most often found in the subcutaneous tissues• Lipomas also occur in the deeper tissues such as the intramuscular septa, thoracic cavity, abdominal organs, and the GI tract• Histologically, lipomas are composed of mature adipocytes arranged in lobules, surrounded by a fibrous capsule• Infiltrating lipomas are non-encapsulated benign lesions with extensions into muscle• Variants of lipomas include angiolipoma, pleomorphic lipoma, spindle cell lipoma, and adenolipoma +++ Epidemiology + • Lipomas are identified in all age groups but most commonly appear first between the ages of 40 and 60• Multiple lipomas (lipomatosis) associated with hereditary syndromes:-Gardner syndrome-Madelung disease• Hereditary multiple lipomatosis-Adiposis dolorosa (Dercum disease)-Multiple endocrine neoplasia type 1 +++ Symptoms and Signs + • Nontender, oval, mobile subcutaneous masses• Characteristic soft, doughy texture• Overlying skin normal• Deeply positioned lipomas typically present as nontender, nonmobile, soft-tissue masses +++ Imaging Findings + • MRI -Demonstrates the extent of the lesion -May be able to differentiate between lipoma and liposarcoma-Useful for deep lesions and/or when malignancy is suspected + • Lipoma• Fibroma• Epidermoid cyst• Hemangioma• Desmoid tumor• Soft-tissue sarcoma (especially liposarcoma)• Cutaneous metastases• Nodular subcutaneous fat necrosis +++ Rule Out + • Soft-tissue sarcoma + • Thorough history and physical exam• When malignancy is suspected, a MRI may be indicated, especially for large or deep-seated lesions + • Surgical excision of symptomatic or enlarging lesions• Lesions > 4 cm should be approached with an incisional biopsy to confirm benign histology prior to complete excision +++ Surgery +++ Indications + • Symptomatic lipoma• Enlarging soft-tissue mass• Cosmetic considerations +++ Medications + • Kenalog steroid injection is an alternative to excision (results in fat atrophy) +++ Treatment Monitoring + • Physical exam to detect "recurrence" +++ Complications + • Surgical infection• Ecchymosis• Hematoma +++ Prognosis + • Uniformly excellent +++ References ++Shelly MJ. MacMahon PJ. Eustace S Radiology of soft tissue tumors including melanoma. Cancer Treatment & Research. 2008, 143:423-52 [PubMed: 18619227] ++Dalal KM. Antonescu CR. Singer S. Diagnosis and management of lipomatous tumors. Journal of Surgical Oncology. 2008, 97(4):298-313. [PubMed: 18286473] Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.