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Suggest treatment for painful lipomas on chest

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Posted on Wed, 25 May 2016
Question: I have multiple lipomas some on my chest. When pressed some of them are painful. I suffer from chest area pains which do not become worse with exercise
doctor
Answered by Dr. T Chandrakant (44 minutes later)
Brief Answer:
FNAC and preferably excision biopsy of tender lipomas.

Detailed Answer:
Hi.
Thanks for your query, albeit short and specific.
To recapitulate male/57 - have multiple lipomas - some on chest and painful when pressed - suffer from chest area pains which do not worsen on exercises....

Lipomas are not tender and hence need careful clinical evaluation, examination and further investigations like ultrasonography and FNAC- fine needle aspiration cytology. Ideally these should be excised and sent for histopathology for the following reasons:
1. you get rid of the disease or lumps which are not a part of the healthy human body.
2. you get confirmed diagnosis and a chance to start on any further management if needed as per the histopathology examination.

The cause of pains that do not get worsen on exercises can be due to any lesions that do not arise from ribs and muscles.
Please see and tell me whether this painful area is more painful on applying local pressure on these points?

I hope this answer helps you, please feel free to ask for further relevant queries if you feel that there is a gap of communication.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (21 minutes later)
Thanks very much for the prompt and useful reply.

My father also has several lipomas in more or less the same places. He is 88 and they do not seem to have bothered him. I have them in many places. I think the medical term is familial lipomatosis. Some of the lipomas are painless others painful if pressed. I noticed that my chest pains become worse or even initiated by pressing on some of the lipomas. The pain feels the same as I get when pressing on a couple of lipomas in my arms, albeit it can last longer on the chest. The ones in the arms recover soon after. I stop pressing.
doctor
Answered by Dr. T Chandrakant (7 minutes later)
Brief Answer:
familial multiple lipomatosis.

Detailed Answer:
Thanks for your appreciation and nice feedback.
Yes, it is familial multiple lipomatosis.
Ideally lipoma is always expressed in terms of painless freely XXXXXXX lump.
It is possible that the tenderness (pain on pressure) could have been due to long standing nature and that some nerve endings grow a bit larger than expected to give tenderness.
Otherwise they should ideally be painless irrespective of the size and site.
Hence the decision about FNAC/Excision biopsy.
it is always better to be certain and get the most tender lipoma biopsied.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (5 minutes later)
I forgot to mention that the upper ribs can be tender with the pain worsening when pressed. But the latter does not happen invariable or even frequently. It is as if they must be sensitised by something g. In fact it seems as if it is not the bones but the muscle or skin on top of them which is tender and worsens when pressed.
I suffer from GERD which is perfectly controlled with Omeprazole. The pain never becomes worse when I eat of swallow. When the chest pain is there is does not necessarily limits itself, or indeed invariably involves the lipomas
doctor
Answered by Dr. T Chandrakant (9 minutes later)
Brief Answer:
Most probably costochondritis

Detailed Answer:
This is most probably costochondritis.
The joints of the ribs with sternum or that part of the ribs that has cartilagenous part can present like this, usually the cause scan not be pin pointed.
The most probable causes can be psychological or related to stress/anxiety, flu or any other infection like colitis and so on.
You would observe that when there is no problem at all, the pain/tenderness would be minimal or absent.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (5 minutes later)
Thanks very much, doctor. One final, unrelated, question. Could one be allergic to only some alcoholic drinks? I can get red after drinking some alcoholic drink but this does not always or often happens with all alcoholic drinks. I am a very occasional alcohol drinker.
doctor
Answered by Dr. T Chandrakant (20 minutes later)
Brief Answer:
Certainly yes.

Detailed Answer:
This again is a related question:
Yes, one can be very well allergic to some of the alcoholic beverages that do not suit at all and can enhance the costochondritis and such disorders.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (35 minutes later)
Does that mean one is allergic to alcohol or to additives commonly used in alcoholic drinks. I am asking as I understand such allergies increase the problems with the oesophagus in those suffering from GERD. Or is this something specific to non Europen individuals ( e.g., alcohol intolence among the Chinese).
doctor
Answered by Dr. T Chandrakant (10 minutes later)
Brief Answer:
Must be to both

Detailed Answer:
This applies to all humans all over the world.
It would be difficult to say whether this is allergy to alcohol or to preservatives as making an alcoholic beverage/drink is a complex procedure and well guarded in many distilleries.
Yes, this is dangerous to people with GERD, esophagitis and GI problems.
That is why alcoholic liver problems are known at the number of sufferers is large.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. T Chandrakant

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Suggest treatment for painful lipomas on chest

Brief Answer: FNAC and preferably excision biopsy of tender lipomas. Detailed Answer: Hi. Thanks for your query, albeit short and specific. To recapitulate male/57 - have multiple lipomas - some on chest and painful when pressed - suffer from chest area pains which do not worsen on exercises.... Lipomas are not tender and hence need careful clinical evaluation, examination and further investigations like ultrasonography and FNAC- fine needle aspiration cytology. Ideally these should be excised and sent for histopathology for the following reasons: 1. you get rid of the disease or lumps which are not a part of the healthy human body. 2. you get confirmed diagnosis and a chance to start on any further management if needed as per the histopathology examination. The cause of pains that do not get worsen on exercises can be due to any lesions that do not arise from ribs and muscles. Please see and tell me whether this painful area is more painful on applying local pressure on these points? I hope this answer helps you, please feel free to ask for further relevant queries if you feel that there is a gap of communication.