Dermatologic Manifestations of Lipomas 

  • Author: Robert A Moraru, MD; Chief Editor: William D James, MD   more...
 
Updated: Jan 12, 2012
 

Background

Lipomas are benign tumors composed of mature fat cells. They are the most common benign mesenchymal tumor. Lipomas are found in the subcutaneous tissues and, less commonly, in internal organs. Lipomas usually present with little difficulty in diagnosis or morbidity. Lipomas typically develop as discrete rubbery masses in the subcutaneous tissues of the trunk and proximal extremity. Lipomas usually are a few centimeters in size and can be removed by surgical excision or liposuction. Also see the eMedicine general surgery article Lipomas.

Next

Pathophysiology

Lipomas differ biochemically from normal fat by demonstrating increased levels of lipoprotein lipase and by the presence of a larger number of precursor cells.

Approximately 60% of solitary cutaneous lipomas display clonal alterations. The most common alteration involves a breakpoint on bands 12q13-15. Karyotype aberrations also have been noted on arms 6p and 13q. Multiple lipomas do not display these alterations.[1]

Previous
Next

Epidemiology

Frequency

International

In one study in a Scandinavian population, 43% of benign mesenchymal tumors were lipomas.

Mortality/Morbidity

No fatalities are reported with cutaneous lipomas. Mild tenderness occasionally is associated with the tumors. Angiolipomas often are tender.

Sex

Solitary lipomas are seen predominately in women. Multiple lipomas occur more frequently in men.

Age

Lipomas can occur at any age; however, they usually arise in early adulthood and are rare in children and infants.

Previous
Proceed to Clinical Presentation
 
 
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.

Specialty Editor Board

Janet Fairley, MD  Professor and Head, Department of Dermatology, University of Iowa, Roy J and Lucille A Carver College of Medicine

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.

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

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.

Rosalie Elenitsas, MD  Herman Beerman 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 Academy of Dermatology and American Society of Dermatopathology

Disclosure: Lippincott Williams Wilkins Royalty Textbook editor; DLA Piper Consulting fee Consulting

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M 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, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

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

References

  1. Tallini G, Dal Cin P, Rhoden KJ, 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].

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

  3. Gomes da Silva R, Detoffol Bragança R, Ribeiro Costa C, Torres de Melo L, Weiss Telles R, Costa Silva L. Multiple symmetric lipomatosis. J Cutan Med Surg. Jul-Aug 2011;15(4):230-5. [Medline].

  4. 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].

  5. 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].

  6. Hansson E, Svensson H, Stenram U, Brorson H. Histology of adipose tissue inflammation in Dercum's disease, obesity and normal weight controls: a case control study. J Inflamm (Lond). Sep 28 2011;8(1):24. [Medline]. [Full Text].

  7. Miyakura T, Irisawa R, Miyamoto M, Iwaya K, Yamamoto T, Tsuboi R. An atypical case of atypical lipomatous tumor. Am J Dermatopathol. Dec 2008;30(6):590-2. [Medline].

  8. 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].

  9. Kuwano Y, Ishizaki K, Watanabe R, Nanko H. Efficacy of diagnostic ultrasonography of lipomas, epidermal cysts, and ganglions. Arch Dermatol. Jul 2009;145(7):761-4. [Medline].

  10. Sachdeva MP, Goldblum JR, Rubin BP, Billings SD. Low-fat and fat-free pleomorphic lipomas: a diagnostic challenge. Am J Dermatopathol. Jul 2009;31(5):423-6. [Medline].

  11. 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].

  12. 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].

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

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

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

  17. Couto RA, Mulliken JB, Padwa BL, Hassanein AH, Rogers GF, Kulungowski AM, et al. Facial infiltrating lipomatosis: expression of angiogenic and vasculogenic factors. J Craniofac Surg. Nov 2011;22(6):2405-8. [Medline].

  18. 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].

  19. 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].

  20. 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].

  21. 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].

  22. 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].

  23. 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].

  24. 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].

  25. 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].

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

 
Previous
Next
 
A 43-year-old white man with a 3- to 4-year history of a slow-growing asymptomatic growth on his right shoulder.
A 43-year-old man with a slow-growing asymptomatic growth.
Surgical excision of a 6-cm lipoma on the back of a 54-year-old man using the squeeze technique.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
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.