Post-traumatic pseudolipoma

Last revised by Henry Knipe on 17 Jan 2022

Post-traumatic pseudolipomas, also known as post-traumatic lipohypertrophy, are prominent increases in the volume of subcutaneous adipose tissue or even benign tumors arising at the location of a preceding blunt soft tissue trauma 1.

Focal palpable mass, not tender and with no signs of active inflammation. Laboratory tests are usually normal 2.

There have been two types of post-traumatic pseudolipomas described in regards to mechanism:

  • repetitive blunt trauma, e.g. patients carrying heavy loads on the shoulders 1,2
  • non-repetitive blunt trauma, with a marked gender predominance towards women (12:1); they can develop true lipomas (capsulated) or pseudolipomas (non-capsulated) 2

Two pathogenesis mechanisms have been suggested 1,3:

  • herniation of fat is normally contained under pressure through disrupted fascial layers
  • formation of new true adipose tissue caused by the differentiation of preadipocytes into mature adipocytes after trauma

Post-traumatic pseudolipomas appear as areas of thickened subcutaneous fat rather than as a mass. Signal intensity follows subcutaneous fat although there is no low signal fibrous capsule. Rarely, fibrous septae may be seen. No post-contrast enhancement is seen 1.

Surgery (liposuctions) can be performed for aesthetic reasons 2.

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