![painful lipoma painful lipoma](https://i.pinimg.com/736x/e6/5b/dd/e65bddec485f1e397700cd81023041fd.jpg)
Remain the same size over years or grow very slowly.Are movable and have a soft, rubbery consistency.Are small and felt just under the skin.The cause of lipomas is not completely understood, but the tendency to develop them is inherited. Lipomas are the most common noncancerous soft tissue growth. One or more lipomas may be present at the same time. They are found most often on the torso, neck, upper thighs, upper arms, and armpits, but they can occur almost anywhere in the body. Lipomas aren't cancer and don't turn into cancer. Interestingly, in his seminal paper, he described the lesions as “irregular and even capricious in these cases, but there is, in addition, another important factor to be remembered, and that is: that at some time or other, the enlargement is accompanied by pain", a description which remains characteristic of the disease to this day 3,4.A lipoma is a growth of fat cells in a thin, fibrous capsule usually found just below the skin. The disease was discovered by its eponym Francis Xavier Dercum (1856-1931), an American neurologist, in 1892 3,4. This may include, but is not limited to, analgesics, surgical excision of troublesome lesions, and psychotherapy 2.
![painful lipoma painful lipoma](http://www.vims.ac.in/blog/wp-content/uploads/2017/09/Lipomas.jpg)
No specific treatment exists, and thus management revolves around symptom control 2. occasionally, lipomas will resemble angiolipomas radiographically instead 1.no edema is appreciated around the lipomas on any imaging modality 1.lipomas are generally restricted to the superficial subcutaneous layer 1.symptomatic lipomas may be tender with an ultrasound probe 1.symptomatic lipomas are generally larger in size than their asymptomatic counterparts 1.lipomas are relatively small in size, generally very numerous lipomas, although interestingly only a small number are symptomatic 1.Important features which may indicate a diagnosis of Dercum disease include: Radiographic features are generally almost indistinguishable from ordinary lipomas (see lipoma for in-depth discussion of radiographic features) 1. It has been postulated that instead of inflammation, perhaps these lipomas impinge on nerves or perhaps there is an autoimmune component, however neither theory has garnered much evidence 1,2. Even in cases with inflammatory features, it is unclear if this inflammation is significant in relation to the pain experienced by patients with Dercum disease because such features can be seen in ordinary non-painful lipomas in a similarly obese demographic 1,2. Studies examining the painful lipomas histologically vary in their findings, with some describing essentially unremarkable lipomatous changes while others revealing inflammatory changes 1,2. It is unclear if Dercum disease has any defining pathological features. In association, patients often describe 1-3: The pain associated with these lipomas can often be severe and may be either constant or intermittent 1-3. The primary presenting feature in patients with Dercum disease is multiple painful and tender lipomas that may be located anywhere on the body, although legs and trunk are the most common locations 1-3. It is usually sporadic, however, autosomal dominant forms with incomplete penetrance have been described, but these are thought to make up only a minority of all presentations 1,2. Although the exact incidence is unclear, Dercum disease affects women more than men 1,2.