43-Year-Old Male With Large Bump on Elbow

Published on October 29, 2026

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Differential Diagnosis

• Epidermoid inclusion cyst
• Lipoma
• Neurofibroma
• Sarcoma
• Pilar cyst
• Pilomatricoma

Diagnosis

The correct diagnosis is lipoma. Superficial subcutaneous lipomas are the most common benign soft-tissue neoplasms. They consist of collections of mature fat cells enclosed within thin fibrous capsules. Lipomas can occur on any part of the body and usually develop superficially within subcutaneous tissue. Rarely, they may involve fascia or deeper muscular planes. Malignant transformation of a lipoma into a liposarcoma is rare.

The diagnosis of lipoma is typically made clinically.

What to Look For

• Lipomas present as soft, painless subcutaneous nodules ranging in size from 1 to >10 cm. 
• They occur most frequently on the trunk and upper extremities and can be round, oval, or multilobulated. Frequently, patients may have more than one lipoma.
• Ultrasound examination can be helpful to distinguish a lipoma from an epidermoid or ganglion cyst.

Pearls for Urgent Care Management

• Consider referral to surgery or dermatology for removal if the lipoma is bothersome to the patient.
• Definitive treatment of lipomas (if needed because of pain, cosmesis, or concerns over diagnosis) is surgical removal of the entire capsule. Recurrence of an excised lipoma is not common.
• If a suspected lipoma is firm rather than soft, is rapidly enlarging, or causes pain or restriction of movement, a biopsy is indicated to confirm the diagnosis and exclude malignancy.

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