A lipoma is a fatty lump that most often sits under the skin, but can also develop within muscle or internal organs. When located underneath the skin, they are typically benign, slow-growing, and painless. It is possible to have more than one on the body, so a person with a neck lipoma might have others located in places such as the back, shoulders, arms, abdomen, or thighs.
Why do they Grow?
Sometimes referred to as adipose tumors, lipomas are overgrowths of fatty tissue that develop in a specific location, typically between layers of skin and muscle. This is the case with neck lipomas, which usually lie just beneath the skin’s surface. Researchers and medical professionals don’t know why they develop, but the tendency to develop them runs in families; for example, an inherited condition called familial multiple lipomatosis causes them to grow all over the body. In some cases, a lump might grow in response to an injury in the affected area.
Appearance and Symptoms
A benign neck lipoma looks like a lump underneath the skin. It is usually soft and can be moved or squashed slightly with a small amount of force. Most are between 0.4 inches (1 cm) and 1.2 inches (3 cm) in diameter. While they tend to be painless, some pain can result if a lipoma grows close to nerves.
Lipomas often resemble another type of benign lump called a cyst. Both have similar textures and appearances, so it can be difficult to tell the difference between the two. In most cases only a medical professional can make a conclusive diagnosis.
Most of the time, lipomas are no cause for concern. They typically grow very slowly, and often stop growing altogether once they reach a certain size. Lipomas are benign and cannot turn into cancerous tumors, but there is a type of cancer called liposarcoma that can resemble a lipoma in the early stages. In general, any lump that is painful or tender, inflamed or infected, or has a foul smell or discharge should be examined for diagnosis. A cancerous lump is more likely to grow quickly and cause pain than a benign one.
Diagnosis
Liposarcoma is a rare cancer, but even so it is worthwhile for a person with an undiagnosed lump to have it examined by a professional. Diagnosis usually involves discussion of symptoms and a physical examination. In some cases, a sample of tissue might be removed for a biopsy.
If this cancer is suspected, a patient is typically referred for additional tests, such as a computerized axial tomography (CAT) scan, magnetic resonance imaging (MRI) test, or ultrasound. These allow medical experts to see what the lump looks like inside the body, including how deep it extends into the tissues and whether it is associated with any blood vessels. Diagnosis is then made on the basis of these test results together with the biopsy result.
Non-Surgical Treatment
Most lipomas do not grow very large or cause unpleasant symptoms, and in many cases, no treatment is necessary. Sometimes, a person might wish to have treatment for a growth that causes pain, grows to an uncomfortable size, or is considered unsightly. A lipoma located on the neck could fall into any of these categories, depending on how it affects other tissues in the area.
The preferred treatment is typically one or more steroid injections. Steroids are used because they break down fatty tissue, allowing the body to remove it from the area. If a person is unable to tolerate this treatment, injections of a biological molecule called phosphatidylcholine might be used instead, as it has a similar effect. Over time, the treatment causes the lipoma to shrink with no scarring, although a small lump of tissue usually remains.
Surgical Treatment
If a course of injections doesn't reduce the size of the lipoma, another option is a minor surgical procedure called liposuction. In this treatment, the lump is removed via suction through a small incision, causing much less scarring than open surgery. This procedure requires only a local anesthetic, and most people can go home the same day they are treated. The main disadvantage is that, as with steroid injections, small amounts of fatty tissue are typically left behind.
Lipoma excision, or surgery, is the only treatment that can entirely remove a lump. After surgery, only 1 to 2% grow back. Most of the time, a neck lipoma can be removed in an outpatient center or even a doctor's office. After injection of a local anesthetic, an incision is made in the skin, the lump is removed, and the incision is closed with stitches. A large lipoma, or one that is complicated by association with muscle or nerve tissue, might require a more involved surgical procedure. In these cases, a person might have a general anesthesia in an operating room and perhaps an overnight hospital stay.
