A family history of multiple lipomas usually exists, and an autosomal dominant mode of inheritance is found. Painful lipomas are the hallmark of this rare condition. Lipomas typically occur on the extremities of obese postmenopausal women. Alcoholism, emotional instability, and depression commonly are associated with Dercum disease. Typically, these tender, soft, subcutaneous nodules are present in adolescence.
Tumors frequently are multilobulated and are somewhat firmer than ordinary lipomas.
The associated pain is vague and may be spontaneous or caused by pressure. Hibernomas Tumors are solitary well-circumscribed nodules that typically are asymptomatic. Usually, tumors are located in the interscapular region, axillae, neck, or mediastinum. Histologically, hibernomas are composed of embryonic brown lipoblasts termed mulberry cells because of their appearance. Lipomas present as subcutaneous nodules of 2-10 cm.