Familial multiple lipomatosis

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The arm of a patient with familial multiple lipomatosis. The arm of a patient with familial multiple lipomatosis.jpg
The arm of a patient with familial multiple lipomatosis.

Familial multiple lipomatosis is a hereditary adipose tissue disorder that is characterized by the formation of multiple lipomas that occur in a particular distribution. [1] The lipomas are well-encapsulated, slow-growing, benign fatty tumors. The distribution is defined as being focused in the trunk of the body and extremities. [2] Familial Multiple Lipomatosis can be identified when multiple lipomas occur in multiple family members that span different generations. [2] Some people may have hundreds of lipomas present. [2]

Contents

Symptoms

The source of this disease is from family history, and symptoms most often arise in middle age. [2] [3] Newly formed lipomas frequently present themselves as a bead-like lump under the skin, and become rubbery and movable. [3] They may be seen throughout the body and in some areas more than others, however, it does not make an appearance on the head or shoulders of the individual. [2] The size of those bumps may vary and could possibly get in the way of an individual living their life peacefully. [2] There are usually no feelings of discomfort or pain unless a lipoma has been aggravated or is directly on a nerve. [4] Lipomas that sit over bony areas such as the ribs and lower back can cause discomfort when lying down or receiving any kind of pressure. The age at which familial multiple lipomatosis begins to make an appearance on the individual’s body varies; for some it may be as early as 5 years of age. [4]

Diagnosis

Lipoma ultrasound 110322120428 1206550 Lipoma ultrasound 110322120428 1206550.jpg
Lipoma ultrasound 110322120428 1206550

Familial multiple lipomatosis is usually diagnosed through a physical exam via palpation, medical history and imaging studies such as ultrasound, CT scan, or magnetic resonance imaging (MRI). A CT scan is an imaging method that uses x-rays to create images of cross sections of the body, while an MRI uses powerful magnets and radio waves to create images of lipomas and surrounding tissues. [3] Both tests are useful to establish the diagnosis of multiple symmetric lipomatosis, although magnetic resonance imaging provides more details and may be used when lipomas are large, deep, or have infiltrated muscle fibers or nerves. In some cases, a biopsy of the lipomas may be necessary to confirm the diagnosis. [3]

Differential diagnoses

Causes

The exact cause of FML is not yet known, but there are several theories of different causes: [5]

Treatment

Lipomas removed from the arm of a patient with familial multiple lipomatosis. Lipomas removed from the arm of a patient with familial multiple lipomatosis.jpg
Lipomas removed from the arm of a patient with familial multiple lipomatosis.

The only effective treatments for lipomas caused by familial multiple lipomatosis are liposuction or surgical removal. [6] Steroid injections may also be used to shrink the tumors by causing local fat atrophy. [7] Patients with the condition often seek removal when the lipomas are large, disfiguring, or cause pain. [2] This may be done by a dermatologist or other surgeon. In the majority of cases where one to a few subcutaneous lipomas are being excised, the procedure is done under local anaesthetic and the patient can resume most normal activities immediately afterward. [6] Over-the-counter pain medications are generally sufficient in the following days and long-term scarring is minimal. [6] Regrowth is rare because lipomas are usually well-encapsulated and are therefore removed entirely although more new lipomas may start to grow in the same area. [7]

Therapeutic treatments that are recommended for adipose tissue disorders include improving lymphatic flow through exercise and massage, following an anti-inflammatory diet, and reducing non-disordered fat tissue when necessary. [6] Weight loss has not been shown to eliminate lipomas but may help reduce overall inflammation and influence hormone levels. [6] While there is no total cure for FML to stop the growth of new lipomas, most of the growths can remain untreated and rarely cause medical complications. [1] [7]

In the media

Related Research Articles

<span class="mw-page-title-main">Lipoma</span> Benign tumor made of fat tissue

A lipoma is a benign tumor made of fat tissue. They are generally soft to the touch, movable, and painless. They usually occur just under the skin, but occasionally may be deeper. Most are less than 5 cm (2.0 in) in size. Common locations include upper back, shoulders, and abdomen. It is possible to have a number of lipomas.

<span class="mw-page-title-main">Gardner's syndrome</span> Medical condition

Gardner's syndrome is a subtype of familial adenomatous polyposis (FAP). Gardner syndrome is an autosomal dominant form of polyposis characterized by the presence of multiple polyps in the colon together with tumors outside the colon. The extracolonic tumors may include osteomas of the skull, thyroid cancer, epidermoid cysts, fibromas, as well as the occurrence of desmoid tumors in approximately 15% of affected individuals.

<span class="mw-page-title-main">Benign tumor</span> Mass of cells which cannot spread throughout the body

A benign tumor is a mass of cells (tumor) that does not invade neighboring tissue or metastasize. Compared to malignant (cancerous) tumors, benign tumors generally have a slower growth rate. Benign tumors have relatively well differentiated cells. They are often surrounded by an outer surface or stay contained within the epithelium. Common examples of benign tumors include moles and uterine fibroids.

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<span class="mw-page-title-main">Lipedema</span> Medical disorder – swelling of the legs

Lipedema is a condition that is almost exclusively found in women and results in enlargement of both legs due to deposits of fat under the skin. Women of any weight may develop lipedema and the fat associated with lipedema is resistant to traditional weight-loss methods. There is no cure and typically it gets worse over time, pain may be present, and patients bruise easily. Over time mobility may be reduced, and due to reduced quality of life, patients often experience depression. In severe cases the trunk and upper body may be involved. Lipedema is commonly misdiagnosed and is now becoming known as lipoalgia due to there being no edema.

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<span class="mw-page-title-main">Very long-chain acyl-coenzyme A dehydrogenase deficiency</span> Medical condition

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<span class="mw-page-title-main">Lipomatosis</span> Medical condition

Lipomatosis is believed to be an autosomal dominant condition in which multiple lipomas are present on the body. Many discrete, encapsulated lipomas form on the trunk and extremities, with relatively few on the head and shoulders. In 1993, a genetic polymorphism within lipomas was localized to chromosome 12q15, where the HMGIC gene encodes the high-mobility-group protein isoform I-C. This is one of the most commonly found mutations in solitary lipomatous tumors but lipomas often have multiple mutations. Reciprocal translocations involving chromosomes 12q13 and 12q14 have also been observed within.

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Neural Fibrolipoma is an overgrowth of fibro-fatty tissue along a nerve trunk that often leads to nerve compression. These only occur in the extremities, and often affect the median nerve. They are rare, very slow-growing, and their origin is unknown. It is believed that they may begin growth in response to trauma. They are not encapsulated by any sort of covering or sheath around the growth itself, as opposed to other cysts beneath the skin that often are. This means there are loosely defined margins of this lipoma. Despite this, they are known to be benign. Neural fibrolipomas are often more firm and tough to the touch than other lipomas. They are slightly mobile under the skin, and compress with pressure.

Encephalocraniocutaneous lipomatosis (ECCL), is a rare condition primarily affecting the brain, eyes, and skin of the head and face. It is characterized by unilateral subcutaneous and intracranial lipomas, alopecia, unilateral porencephalic cysts, epibulbar choristoma and other ophthalmic abnormalities. This condition is described as sporadic because it occurs in people without a history of the disorder in their family.

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References

  1. 1 2 Leffell, David J.; Braverman, Irwin M. (1986-08-01). "Familial multiple lipomatosis: Report of a case and a review of the literature". Journal of the American Academy of Dermatology. 15 (2): 275–279. doi:10.1016/S0190-9622(86)70166-7. ISSN   0190-9622.
  2. 1 2 3 4 5 6 7 "Familial multiple lipomatosis | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program". rarediseases.info.nih.gov. Retrieved 2019-11-22.
  3. 1 2 3 4 "Lipomatosis simétrica múltiple | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program". rarediseases.info.nih.gov. Retrieved 2019-11-22.
  4. 1 2 "OMIM Entry - % 151900 - LIPOMATOSIS, MULTIPLE". omim.org. Retrieved 2019-11-22.
  5. RESERVED, INSERM US14-- ALL RIGHTS. "Orphanet: Familial multiple lipomatosis". www.orpha.net. Retrieved 2019-11-22.
  6. 1 2 3 4 5 "Treatment Summary". Fat Disorders Resource Society. Retrieved 2019-11-22.
  7. 1 2 3 "Lipoma - Diagnosis and treatment - Mayo Clinic". www.mayoclinic.org. Retrieved 2019-11-22.
  8. Harvey-Jenner, Catriona (2018-11-12). "11 celebrities who have proudly showed off their scars". Cosmopolitan. Retrieved 2019-11-22.