Soft Tissue Masses (Lipomas, Cysts, and Other Lumps)

What Are Soft Tissue Masses?

A soft tissue mass is a lump that forms in the skin, fat, muscle, or connective tissue. Most soft tissue masses are benign (non-cancerous), but any new or growing lump should be evaluated to confirm what it is and whether it needs treatment.

Common soft tissue masses include:

• Lipomas (benign fatty tumors)
• Epidermoid or “sebaceous” cysts (blocked skin glands)
• Enlarged lymph nodes (reactive nodes)
• Fibromas and other benign growths
• Abscesses (infected collections)
• Less commonly, soft tissue tumors that require imaging or biopsy

What Is a Lipoma?

A lipoma is a benign growth of fatty tissue that forms a soft, rubbery lump under the skin.

Typical Lipoma Features:

• Soft and mobile (moves slightly under the skin)
• Usually painless, but can be tender if pressing on a nerve
• Slow growing
• Common locations include the back, shoulders, arms, thighs, abdomen, and neck

Lipomas are very common and generally harmless, but they can be removed if they cause discomfort, limit movement, grow, or are cosmetically bothersome.

What Symptoms Should I Watch For?

Most benign lumps cause minimal symptoms. However, prompt evaluation is recommended if you notice any of the following red flags:

Red Flags:

• Rapid growth over weeks to months
• Firm, fixed, or deep mass that does not move
• Size greater than 5 cm (about the size of a golf ball or larger)
• Significant pain, numbness, or weakness
• Skin changes, ulceration, or bleeding
• Fever or signs of infection (redness, warmth, drainage)
• A mass that returns after being removed

These signs do not automatically indicate cancer, but they do warrant imaging and/or biopsy to ensure proper diagnosis.

How Are Soft Tissue Masses Evaluated?

Evaluation depends on the size, location, and physical characteristics of the lump.

Common Evaluation Steps:

1. History and physical exam: Duration, growth rate, pain, and prior trauma or infection
2. Ultrasound: Often the first test for superficial lumps to distinguish cysts, lipomas, or vascular lesions
3. MRI (sometimes CT): Used for larger, deeper, or concerning masses
4. Biopsy (if needed): Performed if imaging or exam suggests the mass is not a simple lipoma or cyst

When Is Removal Recommended?

Many lipomas and benign cysts can be safely observed. Removal is commonly recommended when:

• The mass is painful, growing, or repeatedly inflamed
• It interferes with function such as movement, clothing, or work
• The diagnosis is uncertain
• It is cosmetically bothersome
• There are recurrent infections or drainage (common with cysts)

Soft Tissue Mass Removal: How the Procedure Works

Most straightforward soft tissue mass removals are performed as outpatient procedures.

Anesthesia Options:

• Local anesthesia for many superficial lipomas or cysts
• Sedation or general anesthesia for larger, deeper, or multiple masses

Typical Steps:

• A small incision is made over the lump
• The mass is carefully separated from surrounding tissue and removed
• The area is closed with dissolvable stitches and/or skin glue
• The specimen is sent to pathology to confirm the diagnosis

Procedure Time:

Typically 15–45 minutes, depending on the size and location of the mass.

Recovery: What to Expect

First 24–48 Hours:

• Mild soreness, swelling, and bruising are common
• Most patients return to light activity the same day or next day

Work and Activity:

• Desk work: Often next day to 2–3 days
• Strenuous activity or heavy lifting: Usually 1–2 weeks, depending on location

Wound Care:

• Keep the incision clean and dry as instructed
• Expect a small scar that fades over time

Risks and Complications

Soft tissue mass removal is generally very safe. Possible risks include:

• Bleeding or hematoma
• Infection
• Seroma (fluid collection)
• Scar tenderness or thickening
• Wound separation (more common on the back, shoulder, or larger excisions)
• Numbness or tingling near the incision (usually temporary)
• Recurrence (rare for lipomas; higher for cysts if the capsule is not fully removed)

Frequently Asked Questions

Does Every Lipoma Need to Be Removed?

No. Many lipomas are harmless and can be observed unless they grow, cause pain, or raise concern.

How Do I Know If It’s Cancer?

Most lumps are benign. Evaluation using physical exam, imaging, and sometimes biopsy helps determine whether further treatment is needed.

Will It Come Back?

True lipoma recurrence is uncommon when completely excised. Cysts may recur if the lining or capsule is not fully removed.