Fatty lump on the face, head and neck: what it is and when to see a doctor

You have felt a soft little ball under the skin. It doesn't hurt, it moves easily under your fingers, and it grows slowly. Most often this is a lipoma — a benign growth made of fatty tissue.

What a fatty lump and a lipoma are

A fatty lump and a lipoma are the same thing. A lipoma is a benign tumor made of fatty tissue. It develops in the layer of loose subcutaneous connective tissue and can extend deeper, between muscles and vascular bundles, all the way to the periosteum. Benign tumors are not cancer: they grow only in one place and do not spread through the body. A lipoma is usually not dangerous and does not turn into cancer. Quite rarely, a lipoma of the subcutaneous fat turns into a liposarcoma — which is why any lump is best shown to a doctor.

Where fatty lumps appear

Most often lipomas arise where there is little fatty tissue: the upper back, the shoulder girdle, the outer surface of the upper arm and thigh. A lipoma can appear anywhere, including on the forehead; most often on the shoulders, chest, arms, back and thighs. On the scalp, a lipoma feels like a soft, mobile little ball under the skin.

Why a fatty lump appears: causes and risk factors

The issue is not an excess of fat in the cells, but a disruption in its breakdown. Metabolic changes have been described that are associated with a deficiency of regulatory enzyme proteins. The cause of the enzymopathy is a duplication of the long arm of chromosome 12, region 12q13-15, where the loci of the TAG lipase protein gene are located. This protein breaks down fats into energy and water. A lipoma grows not because of active fat storage, but because the pathway of its breakdown is blocked. Familial lipomatosis is distinguished separately: it is inherited in an autosomal dominant manner and manifests at a young age.

What a lipoma looks and feels like

The growth is soft, doughy to the touch. Its size ranges from a pea to several centimeters. If you press on it, it shifts slightly under the skin. It is usually painless and grows slowly. The diffuse form looks like an accumulation of grape-like masses of fat without sharp borders.

How a fatty lump differs from other skin growths and how it is diagnosed

A lipoma is sometimes difficult to distinguish from an atheroma, a hygroma, lymphadenitis and other benign skin tumors. A doctor usually recognizes a lipoma on examination and palpation. If doubts remain, a scan is ordered. A lump under the skin is in rare cases a sign of a more serious disease, so any growth is examined. Ask the surgeon about:

• how long ago the lump appeared and how quickly it is growing;
• what tests are needed to confirm the diagnosis;
• whether observation alone is sufficient;
• what the scar will look like if the growth is removed;
• whether the removed tissue will be checked in a laboratory.

When a fatty lump requires a doctor's examination

You should see a doctor if you find any lump on your body. Specific reasons for an examination: the growth hurts, the skin over it is red or hot to the touch; it is hard and does not move; it is increasing in size. Lipomas are harmless and usually do not require removal. Surgery is discussed if the growth is enlarging or causes problems because of its location. The removed tissue may be sent to a laboratory to confirm the diagnosis. Benign tumors usually do not grow back after removal.

A lump under the skin is not in itself a reason to call an ambulance. 103 or 112 — only in a life-threatening condition (according to general emergency criteria), while pain, redness, heat, hardness or growth of the lump is a reason for a routine doctor's appointment.

This article is for reference and does not replace a doctor's consultation: the nature of a lump is determined by examination.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer