Lumps & Bumps
Lipomas are the most common soft-tissue tumours. These slow-growing, benign, fatty tumours form soft, lobulated masses. More than half of lipomas encountered by surgeons are subcutaneous in location. They rarely cause major problems but can be removed for cosmetic reasons, because they are causing pressure symptoms or because they are over 5 cms and their histology needs evaluating. The majority can be removed under local anaesthetic as a day case procedure.
In the subcutaneous location, the primary differential diagnosis is a sebaceous cyst. Sebaceous cysts are also rounded but they can be differentiated from lipomas by their characteristic central punctum. Treatment requires removal of a small ellipse of overlying skin to avoid entering the cyst, which can usually be done as a day case under local anaesthetic.
Abscesses typically have overlying induration and erythema (redness). Incision and drainage is an appropriate management in the first instance, with the underlying pathology being treated subsequently, when the infection has resolved.
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