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Lipoma

lipoma, lipoma fatty tumor
A lipoma is a benign tumor composed of adipose tissue body fat It is the most common benign form of soft tissue tumor1 Lipomas are soft to the touch, usually movable, and are generally painless Many lipomas are small under one centimeter diameter but can enlarge to sizes greater than six centimeters Lipomas are commonly found in adults from 40 to 60 years of age, but can also be found in younger adults and children Some sources claim that malignant transformation can occur,2 while others say this has yet to be convincingly documented3

Contents

  • 1 Types
  • 2 Causes
    • 21 Other conditions
  • 3 Diagnosis
  • 4 Treatment
  • 5 Prognosis
  • 6 Epidemiology
  • 7 Animals
  • 8 References
  • 9 External links

Typesedit

There are many subtypes of lipomas:4:624–5

  • Adenolipomas are lipomas associated with eccrine sweat glands5:627
  • Angiolipoleiomyomas are acquired, solitary, asymptomatic acral nodules, characterized histologically by well-circumscribed subcutaneous tumors composed of smooth muscle cells, blood vessels, connective tissue, and fat4:627
  • Angiolipomas are painful subcutaneous nodules having all other features of a typical lipoma4:6246
  • Cerebellar pontine angle and internal auditory canal lipomas7
  • Chondroid lipomas are deep-seated, firm, yellow tumors that characteristically occur on the legs of women4:625
  • Corpus callosum lipoma is a rare congenital brain condition that may or may not present with symptoms8 This occurs in the corpus callosum, also known as the calossal commissure, which is a wide, flat bundle of neural fibers beneath the cortex in the human brain
  • Hibernomas are lipomas of brown fat
  • Intradermal spindle cell lipomas are distinct in that they most commonly affect women and have a wide distribution, occurring with relatively equal frequency on the head and neck, trunk, and upper and lower extremities4:6256
  • Neural fibrolipomas are overgrowths of fibro-fatty tissue along a nerve trunk, which often leads to nerve compression4:625
  • Pleomorphic lipomas, like spindle-cell lipomas, occur for the most part on the backs and necks of elderly men and are characterized by floret giant cells with overlapping nuclei4:625
  • Spindle-cell lipomas are asymptomatic, slow-growing subcutaneous tumors that have a predilection for the posterior back, neck, and shoulders of older men4:625
  • Superficial subcutaneous lipomas, the most common type of lipoma, lie just below the surface of the skin3 Most occur on the trunk, thigh, and forearm, although they may be found anywhere in the body where fat is located

Causesedit

The tendency to develop a lipoma is not necessarily hereditary although hereditary conditions, such as familial multiple lipomatosis, may include lipoma development910 Genetic studies in mice have shown a correlation between the HMG I-C gene previously identified as a gene related to obesity and lipoma development These studies support prior epidemiologic data in humans showing a correlation between HMG I-C and mesenchymal tumors11

Cases have been reported where minor injuries are alleged to have triggered the growth of a lipoma, called "post-traumatic lipomas"12 However, the link between trauma and the development of lipomas is controversial13

Other conditionsedit

Lipomatosis is believed to be a hereditary condition in which multiple lipomas are present on the body

Adiposis dolorosa Dercum disease is a rare condition involving multiple painful lipomas, swelling, and fatigue Early studies mentioned prevalence in obese postmenopausal women However, current literature demonstrates that Dercum disease is present in more women than men of all body types; the average age for diagnosis is 35 years14

Benign symmetric lipomatosis Madelung disease is another condition involving lipomatosis It nearly always appears in middle-aged males after many years of alcoholism But, non-alcoholics and females can also be affectedcitation needed

Diagnosisedit

Treatmentedit

Usually, treatment of a lipoma is not necessary, unless the tumor becomes painful or restricts movement They are usually removed for cosmetic reasons, if they grow very large, or for histopathology to check that they are not a more dangerous type of tumor such as a liposarcoma3 This last point can be important as the characteristics of a "bump" are not known until after it is removed and medically examined

Lipomas are normally removed by simple excision15 The removal can often be done under local anaesthetic, and takes less than 30 minutes This cures the great majority of cases, with about 1–2% of lipomas recurring after excision16 Liposuction is another option if the lipoma is soft and has a small connective tissue component Liposuction typically results in less scarring; however, with large lipomas it may fail to remove the entire tumor, which can lead to regrowth17

New methods under development are supposed to remove the lipomas without scarring One is removal by injecting compounds that trigger lipolysis, such as steroids or phosphatidylcholine1518

Prognosisedit

Lipomas are rarely life-threatening and the common subcutaneous lipomas are not a serious condition Lipomas growing in internal organs can be more dangerous; for example lipomas in the gastrointestinal tract can cause bleeding, ulceration and painful obstructions so-called "malignant by location", despite being a benign growth histologically1920 Malignant transformation of lipomas into liposarcomas is very rare and most liposarcomas are not produced from pre-existing benign lesions16 A few cases of malignant transformation have been described for bone and kidney lipomas,2122 but it is possible these few reported cases were well-differentiated liposarcomas in which the subtle malignant characteristics were missed when the tumour was first examined23 Deep lipomas have a greater tendency to recur than superficial lipomas, because complete surgical removal of deep lipomas is not always possible2324

The presence of multiple lipomas is known as lipomatosis and is more commonly encountered in men Some superficial lipomas can extend into deep fascia and may complicate excision Liposarcoma is found in 1% of lipomas and are more likely in lesions of the lower extremities, shoulders and retroperitoneal areas Other risk factors for liposarcoma include large size >5 cm, associated with calcification, rapid growth and/or invasion into nearby structures or through fascia into muscle tissue25

Epidemiologyedit

Approximately one percent of the general population has a lipoma3 These tumors can occur at any age, but are most common in middle age, often appearing in people from 40 to 60 years old15 Cutaneous lipomas are rare in children, but these tumors can occur as part of the inherited disease Bannayan-Zonana syndrome2627

Lipomas are usually relatively small with diameters of about 1–3 cm,28 but in rare cases they can grow over several years into "giant lipomas" that are 10–20 cm across and weigh up to 4–5 kg2930

Animalsedit

Lipomas occur in many animals, but are most common in older dogs, particularly older Labrador Retrievers, Doberman Pinschers and Miniature Schnauzers31 Overweight female dogs are especially prone to developing these tumors and most older or overweight dogs have at least one lipoma3233 In dogs, lipomas usually occur in the trunk or upper limbs31 Lipomas are also found less commonly in cattle and horses, and rarely in cats and pigs3334 However, a pedunculated lipoma can cause entrapment and torsion of the intestine in horses, causing necrosis, colic, and possibly death The intestine becomes wound around the stalk of the lipoma and loses blood supply35

Referencesedit

  1. ^ Bancroft LW, Kransdorf MJ, Peterson JJ, O'Connor MI October 2006 "Benign fatty tumors: classification, clinical course, imaging appearance, and treatment" Skeletal Radiol 35 10: 719–33 PMID 16927086 doi:101007/s00256-006-0189-y 
  2. ^ 'Obesity Gene' Causes Cancer of Fat Tissue, Schepens Scientists Find Archived 2005-04-26 at the Wayback Machine Schepens Eye Research Institute Harvard Medical School affiliate April 26, 2000
  3. ^ a b c d Lipomas at eMedicine
  4. ^ a b c d e f g h James, William D; Berger, Timothy G; Elston, Dirk M 2005 Andrews' Diseases of the Skin: Clinical Dermatology 10th ed London: Elsevier ISBN 0-7216-2921-0 
  5. ^ James, William D; Berger, Timothy G; Elston, Dirk M 2011 Andrews' Diseases of the Skin: Clinical Dermatology 11th ed London: Elsevier ISBN 9781437703146 
  6. ^ a b Rapini, Ronald P; Bolognia, Jean L; Jorizzo, Joseph L 2007 Dermatology: 2-Volume Set St Louis: Mosby p 1838 ISBN 1-4160-2999-0 
  7. ^ Crowson MG, Symons SP, Chen JM "Left cerebellopontine angle lipoma with mild brainstem compression in a 13-year-old female" Otology & Neurotology 
  8. ^ Wallace D December 1976 "Lipoma of the corpus callosum" J Neurol Neurosurg Psychiatry 39 12: 1179–85 PMC 492562  PMID 1011028 doi:101136/jnnp39121179 
  9. ^ Leffell DJ, Braverman IM August 1986 "Familial multiple lipomatosis Report of a case and a review of the literature" J Am Acad Dermatol 15 2 Pt 1: 275–9 PMID 3745530 doi:101016/S0190-96228670166-7 
  10. ^ Toy BR October 2003 "Familial multiple lipomatosis" Dermatol Online J 9 4: 9 PMID 14594582 
  11. ^ Arlotta P, Tai AK, Manfioletti G, Clifford C, Jay G, Ono SJ May 2000 "Transgenic mice expressing a truncated form of the high mobility group I-C protein develop adiposity and an abnormally high prevalence of lipomas" J Biol Chem 275 19: 14394–400 PMID 10747931 doi:101074/jbcM000564200 
  12. ^ Signorini M, Campiglio GL March 1998 "Posttraumatic lipomas: where do they really come from" Plast Reconstr Surg 101 3: 699–705 PMID 9500386 doi:101097/00006534-199803000-00017 
  13. ^ Aust MC, Spies M, Kall S, Jokuszies A, Gohritz A, Vogt P 2007 "Posttraumatic lipoma: fact or fiction" Skinmed 6 6: 266–70 PMID 17975353 doi:101111/j1540-9740200706361x 
  14. ^ http://wwwlipomadocorg/uploads/5/0/4/8/5048532/dd_white_paperpdf
  15. ^ a b c Salam GA March 2002 "Lipoma excision" Am Fam Physician 65 5: 901–4 PMID 11898962 
  16. ^ a b Dalal KM, Antonescu CR, Singer S March 2008 "Diagnosis and management of lipomatous tumors" J Surg Oncol 97 4: 298–313 PMID 18286473 doi:101002/jso20975 
  17. ^ Al-basti HA, El-Khatib HA 2002 "The use of suction-assisted surgical extraction of moderate and large lipomas: long-term follow-up" Aesthetic Plast Surg 26 2: 114–7 PMID 12016495 doi:101007/s00266-002-1492-1 
  18. ^ Bechara FG, Sand M, Sand D, et al 2006 "Lipolysis of lipomas in patients with familial multiple lipomatosis: an ultrasonography-controlled trial" J Cutan Med Surg 10 4: 155–9 PMID 17234112 doi:102310/7750200600040 
  19. ^ Thompson WM 1 April 2005 "Imaging and findings of lipomas of the gastrointestinal tract" AJR Am J Roentgenol 184 4: 1163–71 PMID 15788588 doi:102214/ajr184401841163 
  20. ^ Taylor AJ, Stewart ET, Dodds WJ 1 December 1990 "Gastrointestinal lipomas: a radiologic and pathologic review" AJR Am J Roentgenol 155 6: 1205–10 PMID 2122666 doi:102214/ajr15562122666 
  21. ^ Milgram JW 1990 "Malignant transformation in bone lipomas" Skeletal Radiol 19 5: 347–52 PMID 2165632 doi:101007/BF00193088 
  22. ^ Lowe BA, Brewer J, Houghton DC, Jacobson E, Pitre T May 1992 "Malignant transformation of angiomyolipoma" J Urol 147 5: 1356–8 PMID 1569683 
  23. ^ a b Goldblum, John R; Weiss, Sharon W; Enzinger, Franz M 2008 Enzinger and Weiss's soft tissue tumors 5th ed Mosby Elsevier ISBN 0-323-04628-2 
  24. ^ Fletcher, CDM, Unni, KK, Mertens, F 2002 Pathology and Genetics of Tumours of Soft Tissue and Bone World Health Organization Classification of Tumours 4 Lyon: IARC Press ISBN 92-832-2413-2 CS1 maint: Multiple names: authors list link
  25. ^ EJ Mayeaux Jr 2009 The Essential Guide to Primary Care Procedures, p386, Wolters Kluwer Health ISBN 978-0-7817-7390-4
  26. ^ Buisson P, Leclair MD, Jacquemont S, et al September 2006 "Cutaneous lipoma in children: 5 cases with Bannayan-Riley-Ruvalcaba syndrome" J Pediatr Surg 41 9: 1601–3 PMID 16952599 doi:101016/jjpedsurg200605013 
  27. ^ Gujrati M, Thomas C, Zelby A, Jensen E, Lee JM August 1998 "Bannayan-Zonana syndrome: a rare autosomal dominant syndrome with multiple lipomas and hemangiomas: a case report and review of literature" Surg Neurol 50 2: 164–8 PMID 9701122 doi:101016/S0090-30199800039-1 
  28. ^ Lipoma—topic overview at webmdcom
  29. ^ Hakim E, Kolander Y, Meller Y, Moses M, Sagi A August 1994 "Gigantic lipomas" Plast Reconstr Surg 94 2: 369–71 PMID 8041830 doi:101097/00006534-199408000-00025 
  30. ^ Terzioglu A, Tuncali D, Yuksel A, Bingul F, Aslan G March 2004 "Giant lipomas: a series of 12 consecutive cases and a giant liposarcoma of the thigh" Dermatol Surg 30 3: 463–7 PMID 15008886 doi:101111/j1524-4725200430022x 
  31. ^ a b Adipose Tissue Tumors The Merck Veterinary Manual, 9th ed
  32. ^ Lipomas Veterinary & Aquatic Services Department, Purina
  33. ^ a b Lipoma Virginia Polytechnic Institute and State University
  34. ^ Lipomas Fatty Tumors Veterinary Q & A
  35. ^ The Merck Veterinary Manual 9th ed Merial 2005 ISBN 0911910506 

External linksedit

Classification
  • ICD-10: D17 ILDS D17910
  • ICD-9-CM: 214
  • MeSH: D008067
  • DiseasesDB: 7493
External resources
  • MedlinePlus: 003279
  • eMedicine: med/2720 derm/242
  • Patient UK: Lipoma



  • Illustration from University of Connecticut Health Center
  • Esophageal Lipomatosis MedPix Images from Uniformed Services University of the Health Sciences
  • Lipoma images from DermAtlas
  • humpath #2626

lipoma, lipoma causes, lipoma fatty tumor, lipoma in dogs, lipoma on back, lipoma pictures, lipoma surgery, lipoma symptoms, lipomas in humans, lipomatosis


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