Lipomas: When to Worry About Pain and New Growths

Lipoma

There is a pre-existing lipoma on the left posterior side of the lower back, approximately 2 cm in diameter, which has been present for over a decade.
It causes slight pain when compressed, but its size has remained unchanged, and its color is normal skin tone.
In the past six months, three new small lipomas have appeared on the back, which do not cause pain when compressed.
Is the pain and the appearance of new lipomas considered abnormal? I would appreciate your guidance on this matter.
Thank you!

CC Lee, 40~49 year old female. Ask Date: 2006/08/09

Dr. Cai Yaozhou reply Internal Medicine

Lipomas are quite common benign tumors located in the subcutaneous tissue, composed of fat.
Typically, lipomas are surrounded by a thin fibrous capsule that separates them from the surrounding normal tissue.
However, sometimes this fibrous layer may be absent, making it difficult to distinguish the lipoma from adjacent normal adipose tissue.
Lipomas can occur throughout the body, with the most common locations being the back, shoulders, and nape of the neck.
Some patients may also present with multiple lipomas throughout the body.
Lipomas rarely undergo malignant transformation.
The treatment method is surgical excision, and patients usually request surgery due to the sensation of a foreign body or the prominence of the skin.
In a small number of cases, complete excision may not be possible due to the difficulty in distinguishing the lipoma from the surrounding adipose tissue, leading to recurrence.

Reply Date: 2006/08/09

More Info

Lipomas are benign tumors composed of adipose (fat) tissue and are generally considered harmless. They can occur anywhere in the body but are most commonly found on the trunk, shoulders, and arms. The characteristics of lipomas include their soft texture, mobility under the skin, and generally slow growth. In your case, you have a long-standing lipoma on the left side of your lower back that has remained stable in size for many years, which is a typical presentation for lipomas.

The pain you experience when pressing on the existing lipoma could be due to several factors. While lipomas are usually painless, they can sometimes press against nearby nerves or tissues, leading to discomfort. The fact that the lipoma has not changed in size over the years is a good sign, as stable lipomas are less likely to be problematic.

Regarding the new growths you have noticed in the past six months, it is not uncommon for individuals to develop multiple lipomas over time. The appearance of new lipomas, especially if they are small and not painful, is generally not a cause for concern. However, it is essential to monitor these new growths for any changes in size, shape, or pain level. If they remain stable and asymptomatic, they are likely benign as well.

That said, there are certain situations where you should consider seeking medical advice:
1. Rapid Growth: If any of the lipomas grow significantly in size over a short period, it may warrant further evaluation to rule out other conditions.

2. Change in Characteristics: If a lipoma becomes hard, painful, or changes color, it is advisable to consult a healthcare professional.

3. Multiple New Lipomas: While developing multiple lipomas can be benign, if you notice a sudden increase in the number of lipomas, it may be worth discussing with a doctor, especially if there is a family history of lipomatosis or other related conditions.

4. Pain: If the pain associated with the existing lipoma increases or if the new lipomas begin to cause discomfort, it would be prudent to seek medical evaluation.

In terms of management, if the lipomas are asymptomatic and not causing any functional issues, treatment is usually not necessary. However, if you are concerned about their appearance or if they become painful, surgical removal is a common option. This procedure is typically straightforward and can be done on an outpatient basis.

In conclusion, while your current situation with the lipomas seems stable and typical, it is always wise to keep an eye on any changes. If you have any concerns or if the characteristics of the lipomas change, do not hesitate to consult with a healthcare provider for a thorough examination and appropriate management. Regular check-ups can help ensure that any potential issues are addressed early on.

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