eMedicine Specialties > Dermatology > Benign Neoplasms

Lipomas: Differential Diagnoses & Workup

Author: Robert A Moraru, MD, Staff Physician, Department of Dermatology, St Luke's/Roosevelt Hospital Center, Columbia Presbyterian Medical Center
Contributor Information and Disclosures

Updated: May 8, 2008

Differential Diagnoses

Blue Rubber Bleb Nevus Syndrome
Dermatofibroma
Glomus Tumor
Leiomyoma

Other Problems to Be Considered

Hibernomas
Lipoblastomas
Liposarcomas
Neurofibromas
Epidermoid cysts (occasionally)

Benign symmetric lipomatosis
Obesity
Sialadenitis
Goiter
Lymphatic tumor

Angiolipomas
Dermatofibromas (occasionally)
Blue rubber bleb nevus, eccrine spiradenoma, neuroma, neurofibromas, glomus tumors, granular cell tumors, angiolipomas, leiomyoma; also termed BENGAL

Workup

Imaging Studies

  • CT scanning is indicated in suspected liposarcoma. CT scanning is useful for distinguishing between lipomas and liposarcomas.1

Procedures

  • Fine-needle aspiration is indicated when the diagnosis of liposarcoma is suspected.

Histologic Findings

Lipomas histologically resemble normal fat. When completely excised, a thin fibrous capsule surrounding the aggregate of adipocytes may be seen. Without a clinical or gross description, it often is impossible to distinguish between tumor cells and mature adipocytes.

Lipomas differ biochemically from normal mature fat. Lipomas have increased levels of lipoprotein lipase.

More on Lipomas

Overview: Lipomas
Differential Diagnoses & Workup: Lipomas
Treatment & Medication: Lipomas
Follow-up: Lipomas
Multimedia: Lipomas
References

References

  1. Wolfe SW, Bansal M, Healey JH, Ghelman B. Computed tomographic evaluation of fatty neoplasms of the extremities. A clinical, radiographic, and histologic review of cases. Orthopedics. Oct 1989;12(10):1351-8. [Medline].

  2. Juhlin L. Long-standing pain relief of adiposis dolorosa (Dercum's disease) after intravenous infusion of lidocaine. J Am Acad Dermatol. Aug 1986;15(2 Pt 2):383-5. [Medline].

  3. Reggiani M, Errani A, Staffa M, Schianchi S. Is EMLA effective in Dercum's disease?. Acta Derm Venereol. Mar 1996;76(2):170-1. [Medline].

  4. Matarasso A, Pfeifer TM. Mesotherapy for body contouring. Plast Reconstr Surg. Apr 15 2005;115(5):1420-4. [Medline].

  5. Rohrich RJ. Mesotherapy: what is it? Does it work?. Plast Reconstr Surg. Apr 15 2005;115(5):1425. [Medline].

  6. Rotunda AM, Ablon G, Kolodney MS. Lipomas treated with subcutaneous deoxycholate injections. J Am Acad Dermatol. Dec 2005;53(6):973-8. [Medline].

  7. Berntorp E, Berntorp K, Brorson H, Frick K. Liposuction in Dercum's disease: impact on haemostatic factors associated with cardiovascular disease and insulin sensitivity. J Intern Med. Mar 1998;243(3):197-201. [Medline].

  8. DeFranzo AJ, Hall JH Jr, Herring SM. Adiposis dolorosa (Dercum's disease): liposuction as an effective form of treatment. Plast Reconstr Surg. Feb 1990;85(2):289-92. [Medline].

  9. Rubenstein R, Roenigk HH Jr, Garden JM, Goldberg NS, Pinski JB. Liposuction for lipomas. J Dermatol Surg Oncol. Nov 1985;11(11):1070-4. [Medline].

  10. Bonatus TJ, Alexander AH. Dercum's disease (adiposis dolorosa). A case report and review of the literature. Clin Orthop Relat Res. Apr 1986;251-3. [Medline].

  11. Brodovsky S, Westreich M, Leibowitz A, Schwartz Y. Adiposis dolorosa (Dercum's disease): 10-year follow-up. Ann Plast Surg. Dec 1994;33(6):664-8. [Medline].

  12. Economides NG, Liddell HT. Benign symmetric lipomatosis (Madelung's disease). South Med J. Aug 1986;79(8):1023-5. [Medline].

  13. Gonciarz Z, Mazur W, Hartleb J, Machniak M, Bednarek I, Mazurek U, et al. Interferon alfa-2b induced long-term relief of pain in two patients with adiposis dolorosa and chronic hepatitis C. J Hepatol. Dec 1997;27(6):1141. [Medline].

  14. Held JL, Andrew JA, Kohn SR. Surgical amelioration of Dercum's disease: a report and review. J Dermatol Surg Oncol. Dec 1989;15(12):1294-6. [Medline].

  15. Myhre-Jensen O. A consecutive 7-year series of 1331 benign soft tissue tumours. Clinicopathologic data. Comparison with sarcomas. Acta Orthop Scand. Jun 1981;52(3):287-93. [Medline].

  16. Ruzicka T, Vieluf D, Landthaler M, Braun-Falco O. Benign symmetric lipomatosis Launois-Bensaude. Report of ten cases and review of the literature. J Am Acad Dermatol. Oct 1987;17(4):663-74. [Medline].

  17. Rydholm A, Berg NO. Size, site and clinical incidence of lipoma. Factors in the differential diagnosis of lipoma and sarcoma. Acta Orthop Scand. Dec 1983;54(6):929-34. [Medline].

  18. Solvonuk PF, Taylor GP, Hancock R, Wood WS, Frohlich J. Correlation of morphologic and biochemical observations in human lipomas. Lab Invest. Oct 1984;51(4):469-74. [Medline].

  19. Tallini G, Dal Cin P, Rhoden KJ, Chiapetta G, Manfioletti G, Giancotti V, et al. Expression of HMGI-C and HMGI(Y) in ordinary lipoma and atypical lipomatous tumors: immunohistochemical reactivity correlates with karyotypic alterations. Am J Pathol. Jul 1997;151(1):37-43. [Medline].

  20. Weiss SW. Lipomatous tumors. Monogr Pathol. 1996;38:207-39. [Medline].

Further Reading

Keywords

lipomatosis, Madelung disease, Dercum diseaseadiposis dolorosa, angiolipomas, hibernomas, benign mesenchymal tumors, solitary lipomas, diffuse congenital lipomatosis, benign symmetric lipomatosis, familial multiple lipomatosis

Contributor Information and Disclosures

Author

Robert A Moraru, MD, Staff Physician, Department of Dermatology, St Luke's/Roosevelt Hospital Center, Columbia Presbyterian Medical Center
Robert A Moraru, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

Medical Editor

Janet Fairley, MD, Professor and Head, Department of Dermatology, University of Iowa
Janet Fairley, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Federation for Medical Research, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Rosalie Elenitsas, MD, Associate Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System
Rosalie Elenitsas, MD is a member of the following medical societies: American Society of Dermatopathology
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

William D James, MD, Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System
William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology
Disclosure: elsevier Royalty Other; american college of physicians Honoraria Other

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.