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Detailed chapter

Soft Tissue Masses — General Diagnosis

Lipoma and skin cysts — exam, ultrasound, and MRI when needed

The first step is history and examination: how long it has been present, how fast it grows, whether it hurts, and whether prior infection occurred. Imaging clarifies the diagnosis; biopsy or excision with pathology is used when malignancy is suspected.

Diagnosis · educational illustration

Outcomes of any surgical or interventional procedure may vary from person to person. Please seek a detailed consultation with your physician before any procedure.

© Cengiz Dibekoğlu — illustrative; not for unauthorized use

Figure summary

Hero figure: exam, ultrasound, and MRI pathway for a superficial lump.

Key points

  • What examination checks

    Size, depth, mobility, pain, skin changes, and regional lymph nodes.

    • Superficial + mobile → lipoma or cyst more likely
    • Deep + fixed → imaging required
    • Rapid growth → do not delay evaluation
  • Ultrasound

    Superficial lipomas often show homogeneous fat echogenicity; cysts show a walled structure. Septation, heterogeneous solid areas, or deep muscle-plane invasion raises concern.

  • When is MRI used?

    Key note inside

    MRI may be requested for size over 5 cm, deep location, recurrence, liposarcoma suspicion, or when surgical margins need clearer mapping.

  • Biopsy or excision?

    Small superficial lipomas or cysts may go straight to excision plus pathology. Deep lesions or malignancy concern may need core biopsy or multidisciplinary review.

  • Nevus and pigmented lesions

    Key note inside

    ABCDE criteria and dermoscopy guide pigmented lesions — see the nevus diagnosis chapter for the full pathway.

  • Liposarcoma suspicion

    Key note inside

    Deep, large, or septated fatty masses need MRI and biopsy — see the liposarcoma diagnosis chapter.

Frequently asked questions

  • Is ultrasound enough for every lump?

    Often for superficial masses. Deep, large, or suspicious lesions may need MRI or tissue diagnosis.

  • Can a doctor diagnose lipoma by feel alone?

    Sometimes, but atypical features need imaging — and sometimes pathology.

This page is for education. It is not medical advice and does not replace a visit with your physician.

Medical editor: Assoc. Prof. Cengiz Dibekoğlu, MD · Last medically reviewed: August 2026 · English patient-education chapter.