Dermatology-Online

Lipoma on the head

definition

A lipoma is often referred to as a fatty tumor. It is a benign tumor of the adipose tissue cells (Adipocytes) and is the most common type of tumor that develops from mesenchymal tissue.
Lipomas are visible as a kind of lump under the skin, made up of adipose tissue and enclosed in a capsule made of connective tissue. Lipomas are harmless skin phenomena that some sufferers perceive as bothersome for aesthetic reasons alone.

They are mostly benign (benign) Soft tissue tumors. Only in the rarest of cases do lipomas degenerate and become malignant and become a problem.

They are very often subcutaneous, i.e. directly under the skin. On the head, this type often occurs in the neck area.

In contrast, most lipomas on the head are subfascial lipomas. This means that the fat lump is still under the fascia that surrounds each muscle individually. This type of lipoma usually grows where the forehead meets the hairline and is a bit harder to remove.

Here you can find more information about lipomas on the face and forehead.

Lipomas arise too about 20 percent on the head, so the head is the most common predilection for their occurrence. Benign tumors, which include lipomas on the head, grow slowly and non-invasively, which means that they do not metastasize. Lipomas are often symptom-free and only bother insofar as lumps are noticeable under the skin. Sometimes pressure pain can occur.

Although only a very small percentage of lipomas degenerate, a dermatologist (Dermatologist) should be consulted for histological clarification. The dermatologist usually does a biopsy and sends the removed tissue to a laboratory for evaluation. Lipomas on the head can occur individually or in bulk.

causes

According to the current state of science, why lipomas develop on the head not known.

As causes are Metabolic diseases like Diabetes mellitus or Hyperuricemia (high levels of uric acid in the body) discussed. Genetic predisposition can also play a role in the development, just as inheritance within the family is possible.

In the Neurofibromatosis In addition to neurofibromas, lipomas also appear on the patient's body. Since neurofibromatosis is a hereditary disease is, the theory of hereditary disease is not so absurd, even if it has not yet been proven.

Also that pluripotent mesenchymal cellsthat is actually too Adipocytes should differentiate, degenerate, is up for discussion. Everyone has pluripotent stem cells, which develop into the many different individual cells found in the body. If not everything goes its planned path during this development in the embryonic phase, researchers suspect, develop adipocytes (Fat cells), which continue to divide and multiply, even without having received the appropriate signal from the body. Decoupled cells grow uncontrollably and this is how lipomas develop.

diagnosis

The diagnosis of lipoma on the head is usually easy to make.

At first, patients often notice a small, rubbery bump under the skin. Any bump or lump should be presented to a doctor so that they can rule out a malignant tumor.

Lipomas are clearly demarcated, easily movable tumors. At the very beginning, you can feel a hard area under the skin, which then grows into a lump or bump.

Lipomas on the head are characterized by very slow growth and final size under 5 centimeters. This final size is often only reached after decades, if no action is taken beforehand. In the end, such a bump on the head doesn't look very nice. Of course, exceptions confirm the rule and there have also been cases with larger lipomas. From a diameter of 5 centimeters one speaks of giant lipomas.

Lipomas are mostly superficial under the skin.

For more detailed clarification, the doctor does an ultrasound or an X-ray. With both methods, he can rule out other neoplasms such as cysts or fibroids from the outset. In some cases, a computed tomogram or magnetic resonance tomogram is also ordered. because in up to 50% In some cases, a thin septum can be seen between the lipoma and the surrounding tissue. The septum alone can confirm the diagnosis, it is a phatognomic symptom. That means as soon as this can be seen, the diagnosis is considered confirmed.

Even experienced doctors can only treat a benign lipoma on the head in 80% of the cases can be safely distinguished from a liposarcoma.
In disputed cases, a biopsy is ordered.

Symptoms

There is a lipoma on the head symptomless, it feels like a plump little ball filled with jelly. Sometimes it does hurts with pressure.

The typical pain associated with a lipoma

Lipomas are benign (benign) Tumors that do not infiltrate surrounding tissues. As such, in the vast majority of cases they do not cause pain. In exceptional cases this can still be the case if they are located in unfavorable places and are squeezed when moving. The targeted exertion of pressure on the lipoma can also cause pain without this having to be an indication of a malignant degeneration of the lipoma. However, if, in addition to pain, rapid growth and an immovable structure of the tumor are noticeable, a doctor should urgently clarify the situation. In this case, the growth may be a malicious (malignant) Act liposarcoma. However, liposarcomas are much rarer than lipomas.

Angiolipoma is a special benign form of lipoma. This contains blood vessels that are often formed by blood clots (Thrombi) are clogged, i.e. thrombosed. This often causes pain. Young men in particular are affected by this; half of the patients have multiple angiolipomas at the same time.

Read more on this topic at: Pain from a lipoma

therapy

A lipoma is a benign tumor, that means it is not malignant and must, if it does not disturb or cause pain, not necessarily removed become.

Lipomas on the head often fall ugly on. In these cases the lipoma can surgically removed by a dermatologist or a surgeon become.

Is the lipoma superficial under the skinAs is the case with most cases in the neck, one is enough local anesthesia. The skin becomes with incised with an incision and the lipoma with its connective tissue capsule pushed out. Then the skin is covered with a seam locked again.

At subfacial lipomasthat we often see on Transition forehead to hairline find, surgical removal is a little more complicated. The surgeon must first have the muscle and expose the fascia in order to be able to remove the entire lipoma underneath. Here too, one is usually sufficient local anesthesia to keep the risk of anesthesia as low as possible.
Such deeper lying lipomas on the head can press on nerves and so cause great damageif they are not removed in time.

Stay in both cases scar back that too not necessarily aesthetic are. It must therefore be carefully considered before the procedure whether the lipoma is to be left in situ, if possible, or whether removal is sought.
A newer method to keep scarring as low as possible is that Liposuction. The lipoma is sucked through a very small incision. Especially in the head area, this method guarantees a relatively scar-free result. Although this technology is already used daily by the Liposuction is used, complete removal of the lipoma is sometimes difficult. There is a risk of the lump not residue-free is removed and enlarged again after the operation.

With every surgical procedure there is Risk of bleeding and one Infection of the woundfollowed by a poor healing process, however, these are rare with lipoma removal on the head.

The The tendency of lipomas to degenerate is practically non-existent, so the knot can simply be left and placed under observation, provided it is not perceived as annoying.

Lipoma on the face

Lipomas are benign growths of adipose tissue. There is no danger from them - only in the rarest of cases does degeneration occur. They can grow on all kinds of parts of the body. In the face, they occur when accumulated in the forehead area. A lipoma on the face does not necessarily have to be removed. Often, however, the patient's request is for cosmetic reasons.

The patients have no symptoms in most of the cases. Due to its superficial location, the lipoma seldom presses on structures. In the transition from the forehead to the hair, however, there are also deeper-lying lipomas that lie under the muscle fascia. These can be perceived as annoying by the patient, as they rub against other muscles or vision when the muscles in the face are moved. The deeper lipomas can also cause pain if they happen to be lying in such a way that they press on nerves or vessels. In these cases, surgical removal should definitely be considered.

Furthermore, lipomas can be painful if they are in places where they are squeezed. Most patients describe an uncomfortable feeling or pain when pressure (e.g. pressing on with a finger) is applied to the lipoma.

The excision is very often done on the face for cosmetic reasons. The removal can easily be done in an outpatient operating theater and in most cases a local anesthetic is sufficient. Since lipomas are usually very superficial, the procedure is relatively straightforward. Unfortunately, scarring cannot always be avoided. Surgical excision is particularly useful for lipomas with connective tissue, as these can be suctioned off poorly or not at all.

In the case of lipomas, which are mainly made up of fat, suction can also be used. In principle, less noticeable scars develop here, since such a large surgical access is not necessary. In the long term, however, another intervention may be necessary.

You can find more information on this topic at: Lipoma on the face or forehead

Lipoma on the head in the baby

Lipomas are found relatively often on the head in adulthood; about 4 out of 1000 Patients have lipomas in the head and neck area. They mainly occur in the 5th to 7th century on. Lipomas in children and infants are therefore rather seldom, but can still occur. Most of the time, the problem is only cosmetic, especially since lipomas can grow over many months or years. They rarely cause pain. A surgical removal is possible in any case, but is usually only carried out when the child is a little older.

In any case, it is advisable to watch the growth regularly. Particular attention should be paid to the rapid growth of the overgrowth and whether it can be moved to its surroundings. Immovability, rapid growth and pain are pretty sure signs of a malicious (malignant) Degeneration of the lipoma.

Figure lipoma

Lipoma - adipose tissue growth
a - epidermis (2 + 3 + 4) -
epidermis
b - dermis (5 + 6) -
Dermis
c - subcutaneous tissue (7) -
Tela subcutanea

Lipoma -
Adipose tissue growth
Horny layer - Stratum corneum
Cornifying layer
(light layer
and granular layer) -
Stratum lucidum and
Stratum granulosum
Germ layer (prickly cell layer
and base layer) -
Stratum spinosum and
Stratum basale
Papillary layer -
Stratum papillary
Network layer -
Stratum reticularre
Fat tissue (fat pads)
Fat cells - adipocytes