Objective: Benign subcutaneous
lipomas can cause
musculoskeletal pain and nerve impingement. We hypothesized that the potent lipolytic and atrophic effect of 40mg/mL
triamcinolone acetonide would
atrophy symptomatic
lipomas so surgical excision could be avoided. Design: This was a cohort study. Setting: This study took place in an ultrasound injection clinic. Participants: Eight subjects with painful symptomatic
lipoma were included. Measurements: Preprocedurally, the margins of the
lipomas were palpated and marked with ink, then measured in centimeters (cm). Small
lipomas (1-3cm) were injected with 40mg
triamcinolone acetonide, while large
lipomas (4-6cm) were injected with 80mg of
triamcinolone acetonide. The subjects were reassessed at a four-month follow-up appointment and then again at one year and two years after the procedure. Results: Pre-injection, all eight subjects had symptoms related to impingement or
pain with compression of the
lipoma. At four months post-injection, none of the patients had symptoms attributable to the
lipoma (p<0.001). The mean
lipoma palpable dimension was 5.0±1.2cm prior to the injection and was 2.0±1.1cm at four months after the injection, with a significant mean 3.0±0.3cm (60%) reduction in
lipoma dimensions (p<0.001). Two subjects demonstrated some mild
hypopigmentation of the skin at four months post-injection. Within two years, three
lipomas had symptomatically recurred, one of which was removed surgically and the two of which were reinjected. There were no
infections or other serious adverse reactions that occurred. Conclusions: For individuals with painful subcutaneous
lipoma,
intralesional injection of 40mg/mL of
triamcinolone acetonide is an effective and safe alternative to surgical excision or injection of
sclerosing agents and should be considered as a reasonable therapeutic alternative in select patients.