Lipoma

For 2 years, an asymptomatic mass had been present in the left iliac crest area of a 6-year-old boy. The soft, rubbery, lobulated mass was not attached to the overlying skin or to the underlying structures. Drs Alexander K. C. Leung and Justine H. S. Fong of Calgary, Alberta, diagnosed lipoma. Lipomas are benign collections of fatty tissue that occur most frequently in the subcutaneous tissue of the posterior neck, shoulders, extremities, abdomen, and back. Microscopic examination reveals that they are composed of normal adipocytes arranged in lobules and surrounded by a thin connective tissue capsule. These usually solitary and isolated lesions generally develop during the fourth and fifth decades of life; however, children also can be affected. Rarely, lipomas may be associated with Gardner syndrome, Proteus syndrome, Madelung disease, congenital lipomatosis, and hereditary multiple lipomatosis. Most small and asymptomatic lipomas require no treatment. When treatment is desired, options include surgical excision, corticosteroid injections, and liposuction. This patient’s family was assured of the benign nature of the condition; they chose to have the lipoma managed conservatively. Periodic follow-up visits were scheduled; the parents were cautioned to seek medical attention immediately if the patient’s lesion suddenly enlarged.