What clinical features differentiate a lipoma from other soft tissue masses in primary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Clinical features that differentiate a lipoma from other soft tissue masses in primary care include its typical presentation as a soft, mobile, painless, and slow-growing subcutaneous lump. Lipomas are usually well-circumscribed, non-tender, and have a characteristic doughy or rubbery consistency on palpation, distinguishing them from firmer or fixed masses that may suggest malignancy or other pathologies .

They commonly occur in the subcutaneous tissue and are not usually associated with skin changes, systemic symptoms, or rapid growth, which are red flags warranting further investigation or referral .

In contrast, other soft tissue masses may present with pain, rapid enlargement, fixation to underlying structures, or overlying skin changes such as ulceration or erythema, which are less typical of lipomas .

Imaging characteristics described in the literature support these clinical findings: lipomas typically appear as homogeneous, well-defined fatty masses on ultrasound or MRI, without invasive features, whereas other soft tissue tumors may show heterogeneity, irregular borders, or infiltration .

Therefore, in primary care, the combination of a soft, mobile, painless, slow-growing lump with typical imaging features strongly suggests a lipoma, helping to differentiate it from other soft tissue masses .

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