A 70 year old man presents with a growth on his abdomen that is frequently traumatized by clothing. The lesion was first noted approximately 2 years ago and has gradually increased in size. Examination reveals a flesh-colored, polypoid projection with a firm base. Palpation does not elicit tenderness. No similar lesions are noted elsewhere.
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The patient underwent excisional biopsy that revealed adipose tissue entrapped within bundles of collagen, a finding indicative of a pedunculated lipofibroma. The most common type of these soft fibromas are skin tags (acrochordons), which occur in approximately 25% of men and women and are characterized by pedunculated lesions that range in color from flesh-toned to hyperpigmented. The most common locations of these lesions are the axilla, followed by the neck and inguinal regions.1
The pedunculated lipofibroma is uncommon. It most frequently arises on the trunk and can reach several centimeters in diameter.2,3 The diagnosis is confirmed by histopathology that reveals mature adipocytes within a reticulated, fibrotic dermis.4 Simple excision is curative.
Stephen Schleicher, MD, is director of the DermDox Center for Dermatology, as well as an associate professor of medicine at Commonwealth Medical College and a clinical instructor of dermatology at Arcadia University and Kings College.
1. Habif TP. Skin tags (acrochordon) and polyps. In: Clinical Dermatology. 5th ed. Amsterdam, NE:Elsevier; 2010:784.
2. Nogita T, Wong TY, Hidano A, Mihm MC Jr, Kawashima M. Pedunculated lipofibroma. A clinicopathologic study of thirty-two cases supporting a simplified nomenclature. J Am Acad Dermatol 1994;31(2 Pt 1):235–240
3. Tsai CC, Lee JJ, Chen CK, Cheng SP. Cauliflower-like lesion on the buttock: a quiz. Pedunculated lipofibroma. Acta Derm Venereol. 2009;89(6):669, 671.
4. Lane JE, Clark E, Marzec T. Nevus lipomatosus cutaneus superficialis. Pediatr Dermatol. 2003;20(4):313–314.