Lipomatosis: Symptoms, Causes & Treatment

Lipomatosis is the presence of multiple lipomas in the skin. Lipomas are small, benign growths made up of fat cells that tend to build up mainly in the abdomen and back, but they can also affect internal organs.

This condition is also known as multiple symmetric lipomatosis, Madelung disease, or Launois-Bensaude adenolipomatosis. It may be linked to genetic factors or prolonged corticosteroid use, for example.

Treatment for lipomatosis is managed by a dermatologist or a primary care provider. Depending on the type of lipomatosis and how it presents, options may include surgery, liposuction, or medications in some cases.

Main symptoms

The main symptoms of lipomatosis are:

• Round lumps under the skin (lipomas), mainly on the neck, back, shoulders, and abdomen;

• Tingling and cramps in the legs and arms;

• Foot ulcers;

• Difficulty moving around or walking.

In some cases, depending on where the tumors are located, lipomatosis can also cause heart palpitations, excessive sweating, erectile dysfunction, and trouble swallowing or breathing.

With epidural lipomatosis, symptoms such as spine pain or loss of balance may occur.

Confirming a diagnosis

Lipomatosis is diagnosed by a dermatologist or a primary care provider based on a review of symptoms and a physical exam.

When lipomatosis affects only the skin, additional tests are usually not needed.

However, when it involves internal organs, the doctor may order imaging tests such as an ultrasound, MRI, or CT scan.

Possible causes

Lipomatosis is caused by abnormal growth of adipose (fat) cells, leading to nodules or lumps that may or may not have a capsule around them.

The exact reason this happens is not fully understood, but genetic and environmental factors are known to increase the risk of lipomatosis.

Risk factors

The main factors that can increase the risk of lipomatosis are:

• Obesity;

• High cholesterol or diabetes;

• Prolonged corticosteroid use;

• Heavy, long-term alcohol use;

• Use of anabolic steroids or antiretroviral therapy;

• HIV infection.

The condition may also be associated with inherited traits. In some families, lipomatosis occurs repeatedly over time, which is referred to as multiple familial lipomatosis.

Different types

Lipomatosis is classified based on the area of the body affected by lipomas, such as:

• Abdominal lipomatosis: Affects the abdominal area;

• Epidural lipomatosis: Affects the spine;

• Mediastinal lipomatosis: Affects the area around the heart and part of the airways;

• Pancreatic lipomatosis: Affects the pancreas;

• Renal lipomatosis: Affects the kidneys;

• Diffuse lipomatosis: Affects the entire body and causes an appearance similar to common obesity.

The diffuse form is more common in women and usually does not affect deeper organs and tissues.

Is epidural lipomatosis serious?

Epidural lipomatosis can be serious when fat buildup starts to compress the spinal cord or spinal nerves.

When this happens, symptoms may include back pain, changes in sensation, tingling or numbness in the arms or legs, or loss of bladder or bowel control.

Treatment options

Treatment for lipomatosis should be guided by a dermatologist or a primary care provider. It varies based on location, lipoma size, symptom severity, and the degree of cosmetic discomfort.

The main treatments for lipomatosis are:

1. Medical monitoring

Regular monitoring may be recommended when lipomas are small and do not cause symptoms.

In these cases, routine visits help track whether the lipomas are growing over time.

2. Use of medications

Medications may be recommended to help relieve symptoms, especially when pain is present.

In this situation, pain relievers or anti-inflammatory medications may be used, such as acetaminophen or ibuprofen.

In addition, anticonvulsant medications such as gabapentin may be prescribed to help relieve pain.

3. Corticosteroid injections

A corticosteroid injection may be used to help relieve pain because of its strong anti-inflammatory effect, or to help reduce lipoma size.

These injections may be given directly into the lipoma. In some situations, especially with epidural lipomatosis, they may also be given near nerves to help block pain.

4. Surgery

Surgery is recommended mainly when there are significant cosmetic deformities, when lipomas interfere with breathing or eating, or when there is compression of the spinal cord or spinal nerves.

Depending on the tumor’s location, removal may be done through conventional surgery, liposuction, colonoscopy, digestive endoscopy, or spinal endoscopy.

5. Lifestyle changes

Lifestyle changes mainly include completely stopping alcohol use and quitting smoking to help prevent disease progression.

Weight management is also recommended to lower the risk of obesity-related complications, such as heart disease and diabetes.

Possible complications

The main complications of lipomatosis are:

• Cosmetic deformity of the body;

• Compression of the airways and throat, or the spinal cord and spinal nerves;

• Hoarseness or a weaker voice;

• Reduced neck movement;

• Swelling of the face and neck;

• Chest or back pain;

• Difficulty moving the limbs.

In some cases, cancer can also develop in respiratory organs, especially when there is a history of heavy alcohol use or smoking.