Edith Jones* remembers the day she first noticed a small, egg-shaped lump under her arm. Worried about breast cancer, she made an immediate appointment with her doctor. To her overwhelming relief, the lump turned out to be something called a lipoma, a noncancerous lump of fatty tissue. Over the next few years, however, she was less than pleased to find a dozen more lipomas cropping up on different parts of her body, including her chest, thighs, and upper arms. "I know that these run in my family," she says. "But I was still hoping to escape them."

A lipoma is a round, moveable lump under the skin (they range from pea-sized to the size of an egg, or even larger sometimes). Technically, lipomas are a type of tumor, but don't be alarmed by the term -- they're benign, which means they aren't cancerous. Lipomas are typically small -- less than one inch in diameter -- but can grow much larger in some cases. They are soft to the touch and if you manipulate yours with your fingers you may notice that it moves around a bit. Lipomas grow in the layer of fatty tissue beneath the skin, most commonly on the chest, back, shoulders, neck, and upper arms and thighs. The good news is that a lipoma is likely to grow very slowly; the bad news is that if you have one lipoma you may develop several.

No one knows exactly why lipomas appear. A tendency to develop multiple lipomas runs in families; if you develop a lipoma you may find that other relatives have had the same problem. Sometimes people notice that a lipoma has formed in the same place they previously had a bruise or other injury. But in most cases there is no clear explanation.

Lipomas are more common than you might think -- they are classified by doctors as the most common type of "benign neoplasm," meaning a tumor that's non-malignant.

Approximately one in every thousand people report lipomas. Most people develop lipomas when they are in their late 40s, 50s or 60s and women are more likely to get them than men, but doctors see tthem frequently in people in their 20s and 30s as well.

Not necessarily; many people get a single lipoma and never get more. But a tendency to get multiple lipomas does run in some families and there is even a special name for it: familial multiple lipomatosis. If you have this condition, your lipomas may also be larger and may cluster together. It's no fun, but they are still benign and cause no health problems.

Most lipomas don't hurt, but there is a particular type that does called an angiolipoma. The reason angiolipomas are painful is that blood vessels are scattered throughout the fatty tissue. This type of lipoma is fairly rare. If you have many painful fast-growing lipomas that recur after removal, ask your doctor to investigate whether you may have Dercum's Disease, also called Adiposis Dolorosa. This is an exceedingly rare hereditary condition in which multiple fatty deposits put pressure on nerve endings, causing extreme pain. It tends to go hand in hand with obesity. (They can also be uncomfortable if they show up in unusual locations, such as under the armpit or under a pressure point in your arms, back, or legs.)

If you have lipomas, it's probably much more noticeable to you than anyone else. Still, even a glance at online chats on lipomas underscores the painful feelings they can stir up. One woman in her early 40s who had developed more than 40 lipomas, for example, wrote an online dermatologist for advice. "Although I am mildly overweight after having two children, I am far from obese," she said. "I'm adjusting to the feeling of being 'invaded' by my own body, and I'm grieving the loss of my younger, lump-free body."

A family doctor or dermatologist should be able to recognize a lipoma right away; the giveaway is that the bulge is soft and depresses when your doctor touches it. He may also press around the area to see if the lipoma moves around when he touches it. Your doctor may also order a biopsy, which will confirm his diagnosis by showing that the cells are adipose or fat cells. It's possible to confuse a lipoma with a liposarcoma, a cancerous growth. This is another reason your doctor may order a biopsy of your lipoma (this would be very, very rare).

Since your lipoma is benign, it doesn't actually require treatment -- that is, if it's not causing you any discomfort. "Sometimes a lipoma may be tender because of its location," says Stuart Kaplan, an assistant clinical professor at UCLA Medical Center who also runs a private dermatology practice in Beverly Hills. Large lipomas and those that are located near a muscle tend to be the most uncomfortable. A lipoma can be removed with a very simple surgical procedure; the doctor will give you a local anesthetic, make a small incision, and remove the fatty tissue deposit. "It just pops out like a grape," Kaplan says. Some doctors are also using liposuction to remove larger lipomas or clusters of lipomas. However, the drawback to doing this, Kaplan says, is that your doctor will not be able to biopsy the tissue. "If you pulverize it, then you can't see what you've got."

If your lipomas aren't painful but makes you feel self-conscious wearing a tank top or shorts in the summer, then you may be wondering about having it removed for cosmetic reasons. That is also possible, says Kaplan -- dermatologists remove lipomas all the time simply because they're unsightly or because the patient just wants to have it removed. However, the problem is that you'll probably have to pay for it yourself; most insurers will cover lipoma removal only if there's a medical reason for doing so. There are also a few other disadvantages to surgery: sometimes the surgery leaves a small scar that may be more unsightly than the lipomas; in addition, lipomas tend to grow back.

Jones is sanguine about her lipomas. "Most of my lumps are buried under my skin, with just an eighth of an inch or so showing, so they don't bother me that much," she says. "I miss the way I used to look, but my sweetheart still thinks I look beautiful. But if the lumps ever really get to me, it's nice to know that I can have them removed."

-- Melanie Haiken is a freelance health writer based in San Rafael, California. She is the former health editor of Parenting magazine and the former executive editor of KidCenter.com.

* Edith Jones is a pseudonym.

Further Resources

American Academy of Dermatology

http://www.aad.org/

Archives of Dermatology

http://archderm.ama-assn.org/

References

First published June 27, 2002
Last updated February 28, 2008
Copyright © 2002 Consumer Health Interactive

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