Introduction
A lipoma is a lump beneath the skin caused by an overgrowth of fat cells. They are considered benign tumors or non-cancerous growths. In some cases, lipoma causes pain, complications, or other symptoms like cosmetic problems. Lipomas can occur anywhere on the body where fat cells are present, but they tend to appear mostly on the shoulders, chest, trunk, neck, thighs, and armpits. In less common cases, they may also form in internal organs, bones, or muscles. Lipomas feel soft and may move slightly under the skin when people press down on them. They usually grow slowly over a period of months or years and typically reach a size of around 2cm. There are rare cases where lipomas grow upto10 cm.
Signs & symptoms
Soft, oval-shaped lump just beneath the skin.
It is usually painless unless they affect joints, organs, nerves, or blood vessels. In most cases, they do not cause other symptoms.
A deep lipoma may place pressure on internal organs or nerves and cause associated symptoms. For example, a person with a lipoma on or near the bowels may experience nausea, vomiting, and constipation.
Causes
The exact cause of a lipoma is not known.
A rare condition in which a problematic gene causing one or more lipomas called familial multiple lipomatosis.
Other reasons to be such as:
- Gardner’s syndrome
- Cowden syndrome
- Madelung’s disease
- adiposis dolorosa
- obesity.
- high cholesterol levels in blood
- diabetes
- liver disease
- glucose intolerance
Pathophysiology
Lipomas are common benign mesenchymal tumours. They can develop in all organs throughout the body. The anatomy depends on the site of development. Subcutaneous lipomas are usually not fixed to the underlying fascia. The fibrous capsule must be removed to prevent recurrence.
In the GI tract, lipomas present as submucosal fatty tumours. The most common locations include the oesophagus, stomach, and small intestine. Symptoms occur from luminal obstruction or bleeding.
Duodenal lipomas are mostly small but may become pedunculated with obstruction of the lumen. They may cause pain, obstructive jaundice, or intussusception in younger patients. Mucosal erosion over the lipoma may lead to severe bleeding. Small intestinal lipomas occur mainly in elderly patients. They tend to be pedunculated submucosal lesions. They are more common in the ileum than in the duodenum or jejunum. As with duodenal lipomas, severe haemorrhage or intussusception may occur.
Duodenal lipoma can have a central ulceration where the overlying mucosa has thinned, ulcerated, and bled.
Colonic lipomas are usually discovered on endoscopy. Gentle palpation with a biopsy forceps reveals the soft nature of the submucosal mass. A biopsy specimen of the mucosa reveais underlying fat, the so-called naked fat sign. As with lipomas in other locations, colonic lipomas may cause pain with obstruction or intussusception.
A fatty protrusion of preperitoneal fat termed a “lipoma of the spermatic cord” is found in cases of hernia.
In some cases, lipomatous involvement of endocrine organs, including the thyroid, adrenal glands, pancreas, and parathyroid glands, have been described. Maxillofacial lipomas, including intralingual, parotid, orbito-nasal, maxillary sinusoidal, and parapharyngeal space masses, have also been documented.
In very rare instances, lipomas occur on bones and joints. Involvement of the structural components of the mediastinum, including the airways and pleura, has also been reported. Lipomas may occur in the uterus, ovaries, and broad ligament. Involvement of the heart (causing ventricular tachycardia), superior vena cava, brain, and spinal cord etc can be a medical emergency.
Other fatty tumors include lipoblastomas, hibernomas, atypical lipomatous tumors, and liposarcomas. Lipoblastomas occur almost exclusively in infants and children. They have a benign clinical course and a low recurrence rate after surgical excision. Hibernomas, also rare, derive their name from the morphologic resemblance to the brown fat of hibernating animals. They presumably arise from fat that may occur in the back, hips, or neck in adults and infants. Atypical lipomatous tumors are generally considered to be low-grade sarcomas, with a strong propensity to recurrence but little metastatic potential. Liposarcomas are true mesenchymal malignancies.
Diagnosis
Physical examination
CT scan
biopsy
Ultrasound scan
MRI
Treatments
Lipomas are usually harmless, so a surgical removal is not needed in most of the cases. But a surgery is needed if it:
- Is cancerous
- Is large or growing quickly
- Causes bothersome symptoms, such as pain and discomfort
- Interferes with normal body functions
- Causes distress for cosmetic reasons
- The doctor is unable to confirm is a lipoma rather than another type of tumor
Surgical removal
The method is to make an incision in the skin and then squeeze out the lipoma. It is done under local anaesthesia.
Some lipomas are removed using liposuction by inserting a thin, hollow tube into the lump through an incision and sucking the mass of fat cells out of the body.
After surgery, the doctor will usually send a sample to a laboratory for analysis. A post-operative scar will be there on the area.
Prognosis
Lipomas are harmless, fatty tumours that can form under the skin. They are usually painless and do not require treatment. However, a doctor can surgically remove a lipoma if it is causing pain or other symptoms, or if the person wants to get rid of it for cosmetic reasons.
Complications
Lipomas are benign masses of fat cells. However, experts disagree about whether or not lipomas have the potential to become cancerous. A cancerous mass of fat cells is known as a liposarcoma.
People should always tell their doctor if they notice changes in a lipoma or if more lumps appear. These changes might involve the lipoma:
- increasing in size or suddenly growing very quickly
- being painful
- becoming red or hot
- turning into a hard or immovable lump
- causing visible changes in the overlying skin
These changes may be a sign of complications like carcinoma.
Disease & Ayurveda
Kaphajagranthi
Nidana
Diet and routine which cause vitiation of doshas, mainly Kaphadosha and medodhatu
Purvaaroopa
Not mentioned
Samprapti
Due to the causative factors, vitiated doshas (mainly Kapha&Vaayu ) vititate dhatus maamsa and Raktha. These vitiated doshas along with mamsa & rakta again vitiate medodhatu with special increase in Kaphadosha and develop kaphajagranthi.
Lakshana
Round, raised lump in the body
Whitish or skin colour
Painless
Hard like a rock
Slow development
When pierced, white thick fatty tissue discharge comes out
Divisions
Not mentioned
Prognosis
Kricchrasadhyam
Chikithsa
Samana
Lepanam with Rookshana dravyas
Swedanam
Vimlapanam
Sodhana
Paatanam
Vidaaranam
Then treatment of wound should be done
Commonly used medicines
Kanchanaraguggulu
Varasanadi kashayam
Rasnadi choornam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
Applying turmeric paste
Lose excess weight and shred off the excess fat
Apple cider vinegar intake
Avoid intake of fat in food
Take enough omega 3 fatty acids
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, honey
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from cold climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle.
Yoga
Regular stretching and mild cardio exercises are advised. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://www.ncbi.nlm.nih.gov/books/NBK482343/
https://pubmed.ncbi.nlm.nih.gov/28212122/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274454/
Author information
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