ULTRASONOGRAPHIC FEATURES OF CANINE LIPOMAS

ANTONELLA VOLTA, MATTIA BONAZZI, GIACOMO GNUDI, MARGHERITA GAZZOLA, GIORGIO BERTONI

The purpose of this study was to evaluate the ultrasonographic features of canine lipomas. A group of 94 dogs
with a soft tissue mass was considered. All dogs were examined ultrasonographically and cyto/histologic
examination was performed. Twenty-four dogs, whose mass was diagnosed as a lipoma, were selected. Fifty-five
lipomas were present on the 24 dogs. Fifty-one lipomas were superficial and located subcutaneously. Four
lipomas were deep and located in the paratesticular region. Ultrasonographically, lipomas appeared as oval,
well-defined, encapsulated, striated masses. Veterinary Radiology & Ultrasound, Vol. 47, No. 6, 2006,
pp 589–591.

Key words: dog, lipomas, ultrasonography.

Introduction 1 are extremely underweight, dogs with a score of 9 are

L IPOMAS ARE BENIGN mesenchymal tumor comprised of
adipocytes.1 Lipomas occur in adults and are more
frequently observed in females.2 They arise in sites where
fat is present, particularly in subcutaneous fat tissue.3–5
There is little information on the ultrasonographic appear-
ance of lipomas in the dog.6–12
The purpose of this paper was to report the ultrasono-
graphic features of 55 canine lipomas and to evaluate the
usefulness of sonography in the diagnosis of this common
tumor.
extremely overweight, and a score of 5 is ideal.13
Ultrasonographic examination was performed with a
10 MHz linear transducer with a footprint of 5 cm and a
scan depth of 6 cm. All masses were evaluated for site,
edge characteristics, echostructure and echogenicity,
length, and depth. The edge was evaluated ultrasono-
graphically, considering the presence and the sharpness of
a detectable edge, and whether it was possible to determine
the boundaries. Several masses could not be included
entirely in the image plane, leading to possible errors in
measurement.

Materials and Methods
A group of 94 dogs with a palpable soft tissue mass was
considered. All dogs were examined ultrasonographically
and cyto/histologic examinations were performed.
A retrospective study was carried out selecting 24 dogs
of different breeds, where the cytologic examination was
consistent with a lipoma. Each lipoma was classified, ac-
cording to Enzinger’s classification of human lipomas,3 as
superficial, located in subcutis or in muscles, or deep,
located in the retroperitoneal space, mediastinum, gastro-
intestinal tract, subperiosteal tissue, or paratesticular
region.3 There were 55 lipomas in these 24 dogs.
Being concerned about the possibility that a particular
body condition may predispose the patient to lipoma, body
weights and body condition score (BCS) were reviewed
considering a nine-point scale in which dogs with a score of
From the Sezione di Radiologia e Diagnostica per Immagini (Volta,
Bonazzi, Gnudi, Bertoni), Sezione di Patologia Generale e Anatomia
Patologica Veterinaria (Gazzola), Dipartimento di Salute Animale,
Facoltà di Medicina Veterinaria, Università degli Studi di Parma, Italy.
Address correspondence and reprint requests to Prof. Giacomo Gnudi,
at the above address. E-mail: giacomo.gnudi@unipr.it
Received December 19, 2005; accepted for publication May 19, 2006.
doi: 10.1111/j.1740-8261.2006.00191.x
Results
Nineteen dogs were female and five were male; the
median age was 10 years (range 4–14 years). Four of
the dogs were referred because of the soft tissue mass. The
other 20 dogs were referred for another reason and the
lipoma was an incidental finding.
The BCS was ideal for 10 of the examined dogs, over-
weight for six, heavy for four, and obese for four, with a
mean BCS of 6.1 (overweight). All masses had smooth
margins and were soft. Fifty-one were superficial (49 sub-
cutaneous, two muscular), and four were deep. The 49
subcutaneous lipomas were located on the thoracic wall
(six in the xiphoid region; 22 in the costal region), eight on
the abdominal wall, six on the thoracic limb (shoulder,
axillary, elbow, forearm, and phalangeal region), six on
pelvic limb (thigh and stifle regions), and one on the lum-
bar region. Muscular lipomas were located in the triceps
and between the semitendinosus and semimembranosus
muscles. All deep lipomas had a paratesticular location.
Multiple lipomas were observed in 12 dogs (50%).
Sonographically, lipomas were characterized by thin hy-
perechoic lines compared with the adjacent normal tissue.
ESAOTE, Genova, Italy.

589
590
Fig. 1. An oval striped lipoma in the elbow region.
These lines were parallel to each other and to the alignment
of the surrounding normal tissues (Figs. 1 and 2). All the
lipomas had a sharp edge that defined their boundaries
with the surrounding soft tissue. A hyperechoic capsule
separating the edge of the mass from the surrounding soft
tissue was observed in all tumors. This capsule was com-
plete in 52 lipomas, while it appeared discontinuous in
three (Figs. 1 and 2). Forty-nine lipomas were oval and five
were irregularly rounded. Only one lipoma had an unusual
shape with a pedicle-like structure extending ventrally (Fig.
3). Twenty-six lipomas (47.3%) were isoechoic, 19 (34.5%)
hypoechoic, and 10 (18.2%) hyperechoic to the adjacent
muscular tissue. The length was variable from 1.16 to 8 cm;
the depth ranged from 0.26 to 5.5 cm.
Discussion
In dogs, lipomas commonly occur in the subcutaneous
tissues of the ventral thorax and abdomen of middle-aged
patients, but an intermuscular location is also reported.6
They have occasionally been described within the thorax
and the abdomen, with clinical signs of organ compres-
sion.7,8 The ultrasonographic appearance of superficially
located lipomas in the dog has been described as being well
Fig. 2. Split screen image of an oval/rounded thoracic wall lipoma. Thin
hyperechoic stripes are present. The hyperechoic capsule is marked with
arrowheads.
VOLTA ET AL. 2006
Fig. 3. An oval lipoma with a ventral pedunculation is seen on the costal
region.
organized and hypoechoic in appearance with hyperechoic
speckling.12 In a recently published report of a canine
orbital lipoma, the mass was a well-demarcated hyperecho-
genic lesion when compared with the surrounding orbit.9
Both these descriptions are in accordance with our findings.
Infiltrative lipomas have also been recognized in dogs,
appearing histologically as benign adipocytes, but that
readily invade muscle, fascia, and occasionally bones.10
In humans, lipomas seem to be associated with obesity,
and tumor size tends to increase with body weight. Tumor
size does not, however, decrease with weight loss.3,4 In our
dogs, the BCS was ideal in 10 dogs and overweight to obese
in 14. Not knowing the general hospital population, we
cannot be sure that obesity in dogs predisposes to lipoma
formation, as in humans.
In humans, the sonographic features of lipomas have
been widely discussed;3,4 CT and MR imaging reveal typ-
ical features of the tumor, thus allowing specific diagno-
sis.14,15 The echotexture of human lipomas has been
classified as homogeneous, slightly inhomogeneous, and
inhomogeneous, depending on the presence of hyperechoic
stripes or regions within.5
Lipomas have also been described as being homoge-
neous and hyperechoic, but exceptions have been frequent-
ly observed.4,5,15–17
In this study, the most frequent location of lipomas was
the thoracic wall, followed by the abdominal wall, thoracic
limb, pelvic limb, and lumbar region. Superficially located
lipomas were the most frequent type, and the subcutis was
the most frequently affected tissue. The paratesticular re-
gion was the only location where deep lipomas were ob-
served. Infiltrative lipoma should be considered in the
differential diagnosis in instances like the pedunculated li-
poma and for others deep within muscle.
The striated appearance, sharp edges, and thin hypere-
choic capsule were typical features observed in all dogs.
The striping was interpreted as ingrowth of connective tis-
sue from the capsule becoming the fibrous stroma. The
presence of striations has been described as a sonographic
feature of lipomas in humans4,5,17 and in dogs.11 In this
Vol. 47, No. 6 ULTRASONOGRAPHIC FEATURES OF CANINE LIPOMAS
study, all the soft tissue masses examined had hyperechoic
striations, with a consistently inhomogeneous echotexture.
In this study, most of the masses (47.3%) were isoechoic
to adjacent muscle. Echogenicity can be observer depend-
ent and it is not a reliable or important feature for the
ultrasonographic diagnosis of lipomas.16 It has been pos-
tulated that the sonographic appearance of lipomas de-
pends on their cellularity, and the amount of fat and water
within.5 In vitro, a mixture of fat and water was echogenic,
while pure fat was echo free.18 An acoustic impendance
mismatch exists at fat–water and water–fat interfaces. As
pure fat tumors have few interfaces and less of an acoustic
impendance mismatch, they appear echo-free, whereas
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591
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Conclusions
A striped appearance, sharp edges, and a thin hypere-
choic capsule were typical ultrasonographic features of ca-
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