Lipomas, cysts and lumps under the skin

What a lipoma is

A lipoma is a benign formation made of fatty tissue. It often feels soft, moves slightly under the skin and grows slowly. It may appear on the trunk, shoulders, arms or other areas. When the diagnosis is clear and it causes no problems, monitoring may be enough.

A mass that looks like a lipoma should be reassessed if it grows, becomes painful, is deep or the diagnosis remains uncertain. These features do not automatically mean cancer, but they change the need for investigation. A new mass should not be labeled a lipoma just because a relative has had similar ones.

A cyst is not the same as an abscess

A skin cyst is a cavity lined by a wall, often containing keratin, that is, material produced by skin cells. It may have a small punctum on the surface. When the wall ruptures, the contents can cause inflammation even without bacterial infection. Therefore, not every red cyst necessarily needs an antibiotic.

An abscess is a collection of pus that often causes pain, warmth and swelling. It may need drainage at the relevant service; an antibiotic, when indicated, does not always replace emptying of the collection. Squeezing or piercing at home may damage the area and make treatment harder.

Signs that call for prompt assessment

An unexplained mass that is growing requires a consultation, even if it does not hurt. Depth, fixation to surrounding tissues, recurrence after removal and rapid change are data the doctor must consider. A small size does not by itself exclude the need for investigation.

Pain with spreading redness, fever or a worsened general condition requires assessment the same day. This is especially important in people with diabetes or weakened immunity.

What the surgeon assesses

At the consultation it is determined whether the mass relates to the skin, the subcutaneous tissue or a deeper structure. Questions are asked about growth, previous injuries, discharge, procedures and other symptoms. Masses in the neck, armpit or groin may be lymph nodes and need assessment according to the area and context.

Ultrasound can help distinguish a fluid-filled formation from a solid mass, measure depth and assess other features. The result is not taken apart from the examination. When findings are uncertain or concerning, other imaging and specialist referral may be needed.

When a biopsy or removal is needed

Removal may be discussed for pain, functional obstruction, recurrent inflammation or diagnostic uncertainty. For a cyst, removing only the contents may not be enough to prevent recurrence, because the wall may remain. The timing and technique of the procedure also depend on active inflammation.

When a soft tissue tumor is suspected, the sampling and the biopsy route should be planned by the relevant team. An unplanned removal may make further treatment harder. Histological analysis examines the tissue under the microscope; a description such as “looks benign” is not always equivalent to a final diagnosis.

Frequently asked questions

Does a lipoma turn into cancer? An ordinary lipoma is benign and only very rarely is linked to a malignant formation. The point is that a mass that resembles a lipoma may be something else. Rapid growth, depth, pain or an uncertain diagnosis therefore call for assessment and, when needed, imaging or biopsy.

Should every lipoma be removed? No. When the diagnosis is clear and the lipoma causes no pain or obstruction, monitoring may be enough. Removal is discussed for cosmetic or functional concern, growth, pain or diagnostic uncertainty. The decision is made after the consultation.

Can I squeeze a cyst at home? It is not advised. Squeezing may rupture the cyst wall under the skin, spread the inflammation and make later removal harder. If the cyst has become red or painful, seek assessment instead of piercing it or treating it with irritating products.

Does a cyst come back after removal? It may recur if the wall of the cyst is not removed completely or if part of it remains. Complete removal of the wall lowers the risk but does not eliminate it entirely. When a mass is removed, histological analysis helps confirm the diagnosis.

What you can do until the consultation

Note when you noticed the mass and whether it is changing. A photograph with the same measuring scale can help documentation but does not replace examination. Do not pierce, burn or treat it with irritating products. If it is monitored without intervention, ask for a clear plan for check-ups and the changes you should report.

Care at Tirana Polyclinic: We offer surgical consultation for masses of the skin and subcutaneous tissue. We clarify the need for tests, assessment by another specialty or a procedure at the relevant service. We can review imaging and histology results performed outside the clinic.