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Intramuscular lipoma
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Intramuscular lipoma

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Synopsis

Intramuscular lipoma is a benign subcutaneous mesenchymal neoplasm comprised of fatty cells, arising within the muscle. It is usually solitary but may be present within multiple muscles; it rarely co-occurs with other types of tumors. Intramuscular lipomas are a rare lipoma subtype (less than 1% of lipomas are intramuscular). The majority of intramuscular lipomas are infiltrative.

Intramuscular lipoma is a slow-growing tumor that can occur at any age, but they are most often seen in patients aged 40-70. Intramuscular lipomas occur in the thigh, upper limb, shoulder, and chest wall, but they have also been found in the trunk, neck, head, lower limb, cheek, and tongue.

Intramuscular lipomas are characterized by a soft, palpable, usually painless mass. Symptoms can include pain or limited muscle function in some cases. Other signs and symptoms depend on the location of the intramuscular lipoma:
  • Tongue – trouble with mastication, speech, and deglutition
  • Deltoid region – reduced motion, superficial venous congestion
  • Pectoralis muscle – signs resemble those of breast cancer
  • Supraspinatus muscle – signs resemble those of impingement syndrome
  • Chest wall – signs resemble those of a pulmonary nodule
  • Retropharyngeal space – dysphagia and dysphonia
  • Superior oblique muscle – diplopia and proptosis
In deep-seated lipomas, care must be taken to rule out malignancy with MRI and biopsy.

Management includes marginal excision for well-circumscribed encapsulated intramuscular lipomas. Endoscopic tumor excision may be preferred for upper gastrointestinal tract lipomas. Complete excision is recommended for lobular lipomas, liposuction is recommended for cosmetically sensitive areas of the body, and other techniques may be considered for complete removal and enucleation of the tumor and surrounding capsule. Radiation and chemotherapy are typically not used for this benign growth. Recurrence is considered low.

Codes

ICD10CM:
D17.9 – Benign lipomatous neoplasm, unspecified

SNOMEDCT:
24045002 – Intramuscular lipoma

References

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Last Updated: 02/09/2017
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Intramuscular lipoma
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Intramuscular lipoma : Decreased range of motion
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