Lipoma

General Surgery

Benign tumour of mature adipocytes, commonly in subcutaneous tissue.

History taking

  • Slow-growing, painless, soft swelling for months/years
  • Multiple lipomas: familial lipomatosis, Dercum disease

Examination

  • Soft, lobulated, fluctuant, slip sign positive, non-tender, freely mobile
  • Skin overlying normal

Red flags

  • Rapid growth, pain, induration, deep/intramuscular location, size >5 cm — exclude liposarcoma

Differential diagnosis

  • Sebaceous cyst, neurofibroma, dermoid cyst, soft-tissue sarcoma

Recommended investigations

  • Usually clinical; USG for atypical features
  • MRI if deep, large, suspicious

Diagnosis

  • Clinical ± imaging; histopathology after excision

Initial treatment / management

  • Observation if asymptomatic, small, classical
  • Excision if symptomatic, cosmetic, or atypical features

Prescription examples

  • Post-op: simple analgesia, wound care

Follow-up advice

  • Suture removal 7–10 d; ensure histopathology reviewed

Patient counselling

  • Benign nature, recurrence rare after complete excision

Referral criteria

  • Atypical features, deep lesions for imaging and surgical planning

Clinical pearls

  • Atypical features warrant MRI before excision to plan margins

References

  • Bailey & Love's Short Practice of Surgery 28e

Educational outpatient guide — verify against local guidelines before clinical use.

WardRound

WardRound

Clinical Decisions in Seconds