What Causes Back Lipoma?
Subcutaneous lipoma, or superficial lipoma, is a benign soft tissue tumor composed of mature adipose tissue and occurring superficially (subcutaneously). It is by far the most common mesenchymal tumor. Under normal circumstances, it can occur in any part of the body with fat. It is more common in the back, neck, shoulders, abdomen, breasts and proximal limbs, and it is rare in the face, hands, feet and lower legs. More common in adults, especially in the age group of 30 to 50 years, rare patients under 20 years of age. Subcutaneous lipomas can be single or multiple, mainly manifested as localized tumor bulge, soft texture, no swelling, no tenderness, and a certain degree of activity.
Basic Information
- English name
- subcutaneous lipoma
- Visiting department
- Dermatology, General Surgery
- Multiple groups
- 30-50 years old
- Common causes
- Related to obesity, diabetes, genetics and other factors
- Common symptoms
- Large tumors hinder local movements or cause nerve pain
Causes of subcutaneous lipoma
- The cause of subcutaneous lipomas is not fully understood. Ordinary solitary lipomas are related to the recombination of chromosome 12. The incidence of lipomas is higher in obese people, people with diabetes and higher serum cholesterol levels. Sometimes lipomas are present locally after trauma, but it is unclear whether trauma causes the onset of lipomas. Multiple patients may have a family history.
Clinical manifestations of subcutaneous lipoma
- It usually appears as a subcutaneous, single or multiple, variable-sized, slow-growing, flat, round mass, or lobulated. Single tumors are larger and more common in the abdominal wall, chest wall, lower back, shoulders, and neck. They are spindle-shaped or elliptical, and the long axis is mostly parallel to the skin. Multiple lipoma tumors are small, mostly symmetrical, slightly hard in texture, and may be associated with pain.
- Lipomas generally have no conscious symptoms. Larger tumors can prevent local movements or cause pain due to nerve compression.
- Lipomas can be part of Gardner syndrome. In addition to lipomas, patients are also accompanied by multiple facial osteoma, skin epidermoid cysts, multiple polyps of the colon, and fibroids. Multiple lipomas should also consider the possibility of lipomatosis. The number of tumors can range from a few to several hundred, mainly in the upper body. Some patients are associated with hyperlipidemia, and about 1/3 have a genetic tendency.
- On palpation, soft and elastic masses can be touched, no tenderness, clear boundaries, a sense of false fluctuations, a certain degree of activity, and no obvious abnormalities on the skin.
Subcutaneous lipoma examination
- Histopathological examination
- The pathological sections of lipomas are mostly pale yellow. The tumor is formed by a thin layer of fibrous membrane covering mature fat lobules. The envelope is thin and complete, and the size and shape of fat cells are consistent. There are fatty lobules separated by trabecula. Branches of fibrous tissue and capillaries. There are not many blood vessels in the tissue, and the capillaries are unevenly distributed. A small amount of scattered foam cells can be mixed, and focal mucus degeneration, calcification, ossification, bleeding, necrosis, liquefaction, or yellow tumor-like changes can also be seen. Fibrous tissue is generally not much, if more, it is called fibrolipoma. Larger lipoma pedicles can be cyst-like due to localized blood flow disturbances and changes in liquefaction.
- 2.B-ultrasound
- B-ultrasound can accurately determine the location, size, texture, and whether the tumor is substantial or cystic. Color Doppler ultrasound can directly see the blood supply of the tumor. The rich blood supply may be malignant; it is necessary to do color B-ultrasound. Or angiography, color Doppler ultrasound or angiography can clearly determine its boundary, the integrity of the envelope, and the relationship with the surrounding large blood vessels and nerves and other important tissues.
Diagnosis of subcutaneous lipoma
- The diagnosis of subcutaneous lipoma is mainly based on the characteristics of the mass surface and clinical palpation. When the mass is small or palpation is not typical, imaging methods such as ultrasound can be used.
Subcutaneous lipoma treatment
- The only effective treatment is surgical resection. Smaller lipomas generally do not require treatment without clinical symptoms. For larger solitary lipomas, surgical removal is required. It should be completely removed during the operation.