What is a Lipoma
Lipoma represents not only the most common form of benign tumor of adipose tissue, but also the most common non-cancerous neoplastic condition among all soft tissues.
Incidence
Lipomas can develop in any area of the body and occur in both sexes, but more frequently in men than in women.
Furthermore, the formation of these benign tumors appears to be more frequent in patients over fifty years of age.
Statistics show that 1% of the population is affected by various forms of lipoma: in children, tumoral forms of lipid tissue usually occur in conjunction with the Bannayan-Zonana disease (genetic pathology characterized by the development of hemangiomas and multiple lipomas, associated with macroencephaly).
Features
Lipomas represent palpable subcutaneous reliefs. They appear as accumulations of fat, generally surrounded by a sort of fibrous tissue capsule. They are usually soft, shift due to pressure with the fingers and are not painful to the touch. If they are not removed, they can remain in place for many years.
Usually, these benign formations occur more frequently at the shoulders, neck, arms, abdomen, back and thighs and involve subcutaneous adipose tissue. However, in some cases, lipomas can also occur deeper in the internal organs such as the kidneys or intestine.
In general, lipomas expand up to 15 centimeters, but in some subjects these new growths can evolve into grotesque forms ( giant lipoma ) and weigh even 5 kilos.
Classification
The types of lipomas currently known are many and can be classified according to different factors.
- The conventional lipoma (consisting of the so-called "white fat").
- Ibernoma (otherwise known as glandular lipoma), which is a rare benign tumor that develops in the neck, armpits and mediastinum and that affects brown fat tissue.
- Angiolipoma, consisting of adipose tissue and blood vessels.
- Angiolipoleiomyoma, a circumscribed subcutaneous tumor characterized by smooth muscle cells, blood vessels, lipid and connective tissue.
- Myelolipoma, a type of lipoma consisting of adipose tissue and hematopoietic tissue.
- The racemic lipoma which - unlike all the others - is not surrounded by any capsule.
Another classification of lipomas can be made based on the area of the body in which they occur. In this case, we can distinguish:
- Subcutaneous superficial lipoma: the most common form of lipoma, which occurs just below the surface of the epidermis. It can develop in any area of the body that has fat, but there is a greater incidence in the trunk, thighs and arms.
- Hand-held lipomas: a lipoma that affects the hand.
- Intestinal lipoma: is a benign form of lipoma located in the intestine. It can lead to bleeding.
- Cardiac lipoma: localized close to the heart, the lipoma, despite being benign, could be dangerous. If it increases in size, in fact, there is a risk that the lipoma occludes the heart valves.
- Sacral lipomas: lipoma affecting the sacral region.
- Meningeal lipomas: lipoma that occurs at the level of the meningeal sheaths that could cause neuronal damage.
- Intramural lipomas: lipoma affecting the colon.
Furthermore, lipomas can be classified into:
- Solitary lipomas: circumscribed lipomas, which could however be multiple.
- Multiple lipomas: benign lipomas not clearly defined as solitary lipomas.
Causes
The etiopathological picture underlying the formation of the lipoma has not yet been fully clarified.
However, some researchers believe that genetic predisposition is one of the main factors involved.
Other scholars consider the theory that a relatively large trauma would represent the main cause of the lipoma more reliable; if the tumor is already in place, a traumatic event could enhance its progression (post-traumatic lipoma).
Another theory, instead, relates the lipoma to the alteration of obesity genes, but even in this case there is no scientific evidence.
Symptoms
To learn more: Lipoma symptoms
Beyond the formation of a subcutaneous relief with a soft and mobile texture to the touch, lipomas - normally - do not cause other symptoms. Often and willingly, they are not even visible and remain unchanged and asymptomatic throughout the life of the patient.
Finally, lipomas could cause pain if they grow to compress nerve endings. In the worst - and fortunately rarer - case, however, the pain could be the sign of the conversion into a malignant tumor.
Complications
As mentioned, although it is a rare occurrence, it is not impossible for a lipoma to evolve and become complicated leading to the formation of a malignant tumor.
When this happens we talk about liposarcoma. It is a type of cancer that occurs in any part of the body. It can metastasize giving rise to all the consequences of the case.
When to be alarmed?
Since the transformation into a malignant tumor cannot be completely ruled out, it is always a good idea to keep the lipoma under control, so as to identify any changes or alterations in its characteristics that could represent a buzzer.
In detail, it is necessary to consult the doctor if the lipoma:
- It becomes a hard and / or painful mass;
- Increase in volume very quickly;
- It also grows again after surgical removal;
- It undergoes alterations of any kind.
Diagnosis
The diagnosis of lipoma can be made by the doctor with a simple visual examination. It will then have to evaluate all the symptoms presented by the patient, in order to exclude other possible pathologies.
In some cases - to confirm the diagnosis, thus ascertaining the true nature of the subcutaneous relief - it may be useful to perform a lipoma biopsy, or perform instrumental analyzes such as CT or MRI.
As for the lipomas that develop in correspondence with internal organs (such as, for example, those that form at the level of the gastrointestinal tract), instead, in order to perform a correct diagnosis, recourse to an endoscopy is useful.
Treatment
It is not always necessary to adopt resolutive methods for the lipoma. In fact, as repeatedly stated during the article, in most cases the lipoma is asymptomatic and remains a benign form. So much so that sometimes it regresses spontaneously.
However, tumor removal is recommended when lipomas become a real aesthetic problem, which compromises the image of the person: in fact, lipomas can increase in size, become painful or annoying, become inflamed or hinder movement. In all these circumstances, the surgeon could support the patient to undergo some operations, such as:
- Surgical excision.
- Liposuction.
- Laser treatment.
- Innovative technique that induces lipolysis: in the lipoma a substance is injected (usually steroids or phosphatidylcholine) which favors the lipolysis of the tumor.
To conclude, the lipoma represents one of the least dangerous neoplastic forms and the subject may not even notice the presence of the same. However, the lipoma could remain in the same area in which it originated, not cause any symptoms and regress spontaneously.
Summary
To fix the concepts ...
| Disease | Lipoma: most common form of benign tumor of adipose tissue |
| Features | It can be expanded up to 15 cm in diameter and can reach a weight of 5 kg (rare form). In general, lipomas are palpable, soft and not painful to the touch subcutaneous reliefs. They appear as accumulations of fat and, if not removed, can remain in place for many years. |
| Incidence | It affects 1% of the population and in most cases does not create problems. |
| Areas of interest | They can develop in any area of the body characterized by adipose tissue. |
| Etiopathological framework | Doubtful origin. Etiological hypotheses:
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| Symptoms | Formation of one or more subcutaneous reliefs, generally asymptomatic. Pain may be felt if the lipoma compresses the nerve endings, or if it turns into liposarcoma. |
| Classification | Lipomas can be classified according to the appearance of the cells and the type of tissues that make them up:
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| Diagnosis | Physical examination, instrumental examinations (CT, magnetic resonance) and biopsy. For the lipomas that develop in the internal organs, it is useful to perform an adequate endoscopy. |
| Remedies |
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