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Lipoma vs Hernia: What Is The Difference?

In this blog, we will take compare two medical conditions: lipomas and hernias. We will explain what they are, their symptoms, and the potential confusion between the two due to their similar presentation.

Greta Daniskova

Author - Greta Daniskova

Greta is a BSc Biomedical Science student at the University of Westminster, London.

Greta used MediSearch to find sources for this blog.
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What is a Lipoma?

A lipoma is a slow-growing benign tumour made up of fat (skin). These tumours are usually soft, rubbery masses that are tender and slide in touch. Lipomas may be anywhere, but commonly, it is neck, shoulders, back, abdomen, arms or thighs [1, 2]. Lipomas are not the same thing as lymphomas.

Lipomas tend to be small, less than two inches in diameter, and occur between the skin and muscle. They feel smooth on your fingertips and they move when you press them [1]. But if a lipoma is larger than 10 cm (or 4 in), it is considered a giant lipoma, of which only around 1 per cent of lipomas qualify [3].

However benign they might be, it’s crucial to rule out the possibility of cancer whenever you discover lumps on your body [3].

What is a Hernia?

Hernia is a condition in which a part of an internal organ or tissue bulges through a weakness or defect in the muscles or tissue walls that surround it. This protrusion from compartment to compartment usually results from muscle overstretching or weakness.
This can be caused by:

  • Injury
  • Illness
  • Age
  • Health
  • Genetics [4, 5].

The most common kind of hernia is in the belly but it can happen anywhere. They’re widespread and can strike men, women and even children. Other people are born with weak abdominal muscles and have a higher risk of a hernia [5].

A few different types of hernias are inguinal (groin), umbilical (around the stomach button), incisional (with a scar), hiatal (a small defect in the diaphragm which allows the upper part of the stomach to expand up into the chest), and congenital diaphragmatic (surgery required) [5].

The symptoms of a hernia will depend on the type. Some hernias don’t have any symptoms, and some will, such as:

You can even see a lump underneath your skin where the hernia developed [5].

Hernias are never completely gone and can be life-threatening. Treatment is usually surgery to close up the hole in the muscle wall. But if your hernia is not severe and doesn’t grate on you, the doctor might choose to keep it under observation and give you medicines to avoid any future discomfort [5].

Similarities Between Lipoma and Hernia

There are many things that lipomas and hernias have in common, even in their clinical presentation. They can be equally symptomatic and sometimes confused for each other, especially in the groin.

Cordal and round ligament lipomas will produce hernia-like symptoms even if there is no actual hernia, ie, peritoneal anomaly. They might show up with groin pain and benign findings, and are relatively simple to overlook during laparoscopic hernia surgery [6].

Lipomas can even look clinically similar to groin hernias and, if undiagnosed, could leave a patient with chronic symptoms. It is for this reason that some surgeons are happy to cut and dismember cord lipomas in inguinal hernia surgery [7].

In one case, a lipoma of the femoral fossa was conflated with a femoral hernia because a painful neoplasm was found in the femur [8].

In a different scenario a gluteal lipoma that had moved up into the pelvis, out of place with the rectum and bladder, became a sciatic hernia, accompanied by back pain, inflamed lower abdomen and perianal area, and frequent urine and defecation [9].

Therefore, lipomas and hernias are not the same thing, but they may share symptoms and could be mistaken for each other in the groin region.

Differences Between Lipoma and Hernia

Lipomas and hernias are not the same thing – and are sometimes confused because they’re so similar.

A lipoma is an unmalignant mass of fat. They’re usually smooth, slow-growing, well-defined lumps that can be found just about anywhere the body has fat cells. Typically lipomas are not symptomatic, but they can be painful if they get big enough to cinch surrounding tissues. [10, 11, 12, 13, 14,

Conversely, a hernia happens when an organ or fat squeezing through a pinch of a surrounding muscle or connective tissue. Typically the abdomen is the site of hernias, though it can occur in the upper thigh, belly button and groin. The most common sign of a hernia is an achy lump, sometimes felt when you stand up, sneeze or cough. [ 15, 16, 17, 18]

All that differs between a lipoma and a hernia is the source and composition. A lipoma, for example, forms as fat cells grow in a fibrous capsule; whereas a hernia is the expansion of an organ or tissue through a defect. But lipomas can be mistaken for hernias if they are found in certain areas, such as the groin or femoral area, since they look the same. This sometimes results in diagnosing difficulties [19, 6, 7, 8].

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