Lipoma: is it dangerous, and should it be removed?

What is a fatty lump (lipoma)?

A fatty lump, known medically as a lipoma, is the most common type of benign tumour that occurs in the body's soft tissues. It consists of a collection of mature fat cells surrounded by a thin capsule.

Lipomas typically develop in the subcutaneous tissue and can be found anywhere on the body, but are most frequently seen on the torso (trunk), neck, shoulders, and arms.

Typical Characteristics

Lipomas have very characteristic features that your doctor can often recognise during a simple examination:

• Soft and elastic: The lump feels soft or rubbery to the touch.
• Freely mobile: You can typically push the lump slightly under the skin. It is not attached to the deeper tissue.
• Painless: The lump itself does not usually hurt.
• Slow growth: It grows very slowly over months or years.

Why do lipomas occur?

The reason why some people develop lipomas is unknown. It is important to emphasise that lipomas have nothing to do with being overweight or an unhealthy lifestyle.

In some cases, there may be a hereditary component. Around 20% of patients have multiple lumps, and there are rare hereditary conditions where numerous lipomas are formed.

When should you see a doctor? (Red flags)

The vast majority of lipomas are harmless and require no action. However, it is crucial to see a doctor if you find a new lump or if an existing lump changes.

Contact your doctor if you experience one or more of the following warning signs:

• Rapid growth: The lump grows noticeably over a short period.
• Pain or tenderness: The lump starts to hurt, which may be because it is pressing on a nerve.
• Firm and fixed: The lump is attached to deeper tissue and cannot be moved under the skin.
• Size: The lump is larger than 5 cm in diameter.
• Consistency: The lump feels very hard and lumpy instead of soft and elastic.

Your doctor will perform a clinical examination and, in cases of doubt, may refer you for an ultrasound or MRI scan to determine whether the lump is a typical fatty lump or if it requires further investigation.

Treatment and Management

As lipomas are benign, the most common recommendation is to observe the lump, as long as it does not cause discomfort.

However, treatment may be considered if:

1. The lump is painful or interferes with the function of surrounding tissue.
2. The lump poses a cosmetic nuisance for the patient.
3. There is the slightest doubt about the diagnosis.

Surgical Removal

The removal of lipomas typically takes place via a minor operation under local anaesthesia. Kirurgen.dk removes the lump and its capsule through a small incision in the skin. The tissue is then sent for examination to confirm the diagnosis.

Note regarding cosmetic issues: In many public hospitals, referral criteria have been tightened, and surgical removal of small, cosmetically bothersome lipomas without physical symptoms is often not offered in public hospitals. In such cases, patients are treated by a surgeon in private practice or a dermatologist.

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