Liposurfoma is a newly proposed name for an acquired fibrolipomatous (fat-and-fibrous) growth on the chest wall of some avid shortboard surfers. A 2024 seven-patient case series linked the masses to repeated pressure where the torso rests on a surfboard during prone paddling. It did not establish cold water as a cause. The term remains provisional: prevalence, long-term behavior, and the risk of malignant transformation are unknown, and a surfing history alone cannot identify any particular lump.
What “liposurfoma” means
The word liposurfoma was proposed in a 2024 JAAD Case Reports article for fibrolipomatous masses that developed along recurring surfboard-contact points on the upper abdomen and anterior costal margin. “Fibrolipomatous” describes a mixture of mature fat and fibrous tissue. These are subcutaneous growths, meaning they sit beneath the skin rather than arising from the skin surface itself.
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The proposed entity is based on a small clinical series, not a recognized population-wide diagnosis with established diagnostic criteria. Earlier medical literature was described as isolated reports. There is no population prevalence or incidence figure, so nobody can say what percentage of surfers develop these masses or how common they are in cold-water regions.
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What the seven-patient case series actually found
| Aspect | What was reported |
|---|---|
| Number of patients | Seven surfers in the case series |
| Typical location | Repeated surfboard-contact points over the upper abdomen and anterior costal margin |
| Tissue findings | Sampled lesions contained mature fat and fibrous tissue; the authors considered this compatible with chronic trauma to subcutaneous fat |
| Surgical treatment | Three patients had excision with histologic examination |
| Liposuction | Two patients underwent tumescent liposuction |
| No treatment | Two patients chose observation |
| Activity pattern | Authors reported that masses could enlarge with more surfing and slowly diminish during prolonged inactivity; this was an observation, not a measured dose-response relationship |
One reported patient had a smaller tender nodule within a larger mass. The lesions were generally described as fatty or fibrofatty and apparently benign in their observed course. “Apparently benign” does not mean that every similar lump is harmless, nor does it establish what happens after many years.
Why cold water is not an established cause
Cold-water surfing is part of the title question because many of the affected surfers may spend long sessions in cold conditions. However, the case series did not demonstrate that low water temperature causes liposurfomas. It did not compare cold-water and warm-water surfers, measure tissue temperature, or identify a temperature-dependent biological process.
The evidence points instead to where and how the board presses against the torso. A shortboard surfer spends repeated periods lying prone while paddling. The same edge or surface can contact the upper abdominal wall and lower chest hundreds of times over many sessions. The authors proposed that low-intensity, repetitive compression could produce microtrauma in subcutaneous fat. Cold water may be a coexisting exposure for some surfers, but the report provides no basis for calling it the trigger.
That distinction matters. Saying “cold water causes fatty growths” turns an untested association into a causal claim. The defensible wording is that repeated surfboard pressure is a hypothesis based on lesion location and surfing exposure, while a cold-water mechanism has not been shown.
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How the proposed pressure mechanism might work
The paper’s biological explanation is theoretical. It fits the locations and activity histories, but it has not been proven in laboratory or controlled human studies.
- Repeated contact: Prone paddling repeatedly loads the same chest-wall and upper-abdominal areas against the board.
- Low-grade tissue injury: The authors suggest that many small compression events could disturb subcutaneous fat without producing a dramatic single injury.
- Repair response: Normal tissue repair may recruit fibrous tissue and activate cells involved in fat maintenance and connective-tissue remodeling.
- Fibrofatty enlargement: Over time, that hypothetical repair response could leave a palpable mixture of mature fat and fibrous tissue.
This sequence is a proposed model, not a confirmed pathway. The report did not establish how much pressure, how many sessions, or how many years of surfing would be required. It also did not prove that stopping surfing reverses a lesion; the reported reduction during inactivity was based on limited clinical observations.
Liposurfomas are not the same as surfers’ knots
The names sound related, but the conditions described in the article differ in location, texture and surfing style.
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|---|---|---|
| Liposurfoma | Acquired fatty or fibrofatty chest-wall growth at recurring shortboard-contact points | Subcutaneous mass on the upper abdomen or anterior costal margin |
| Surfers’ knots | Symmetric, rock-hard, dense, callus-like fibrotic masses on the lower extremities of longboard surfers | Lower-extremity fibrotic lesions rather than a chest-wall fatty mass |
| Surfer’s bursa | A rare chest-wall mass mentioned as a possible alternative diagnosis | Distinct entity that can resemble a chest lesion but is not a liposurfoma |
As the case-series authors wrote: “Liposurfomas should not be mistaken for ‘Surfers’ knots,’ which are symmetric rock-hard dense fibrotic callus-like masses on the lower extremity that affect longboard surfers.” The distinction is clinical, not something a person can reliably make by comparing photographs or feeling the lump at home.
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What a liposurfoma may feel or look like
Reported lesions were beneath the skin and composed of fatty or fibrofatty tissue. Their position near a familiar board-contact area may make them noticeable when paddling, lying prone or pressing on the torso. Most were not described as acutely inflamed. At least one patient had a tender smaller nodule within a larger mass.
Those observations are descriptive, not a checklist for self-diagnosis. A soft lump can be an ordinary lipoma, a firm lump can have several causes, and a chest-wall mass can arise from structures other than fat. The fact that someone surfs—or that a lump sits where a board presses—does not prove the proposed diagnosis.
How a clinician evaluates a surfer’s new lump
Arrange an assessment with a qualified clinician for a new, enlarging, painful, fixed, recurrent or otherwise uncertain mass. Evaluation starts with the history and physical examination: when the lump appeared, whether it changes with surfing or rest, whether it is tender, and whether it moves relative to nearby tissue. A clinician will also consider non-surfing causes and the possibility of a different chest-wall or subcutaneous lesion.
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A free scan shows the junk files, broken settings and background clutter dragging Windows down - then fixes them in one click.Free scan · Windows 10 & 11If the diagnosis is not clear, the clinician decides whether additional investigation or tissue sampling is appropriate. The 2024 report used histologic examination for lesions removed in surgery; that pathology provided the mature-fat and fibrous-tissue findings. Do not assume that a mass is a liposurfoma simply because it resembles one of the published cases.
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Seek prompt medical attention if a lump changes quickly, becomes persistently painful, feels fixed, returns after removal, or is accompanied by other concerning symptoms. General guidance for lipomas also supports reassessment when a presumed benign mass changes or the diagnosis is uncertain; that guidance does not validate liposurfoma as a confirmed diagnosis.
Management options reported in the case series
No controlled trial compared treatments, and the case series does not provide reliable success, recurrence or recovery rates. Management is therefore a clinician-led decision based on diagnostic confidence, symptoms, size and location, and the patient’s preferences.
| Option | What the report documents | What cannot be concluded |
|---|---|---|
| Observation | Two of the seven patients chose no treatment | Observation has not been shown to make every lesion shrink or to eliminate future growth |
| Surgical excision | Three patients had the masses removed and examined histologically | The series does not establish a standard operation, cure rate or recurrence rate |
| Tumescent liposuction | Two patients underwent this procedure | It has not been compared with excision for completeness, recurrence or complications |
Removal may be discussed when a lesion is symptomatic, enlarging, diagnostically uncertain or bothersome. The appropriate procedure depends on the individual case, and the published series is too small to rank one approach above another.
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Reducing pressure during surfing: comfort, not treatment
The authors mention a wetsuit with foam padding over the focal pressure area as a comfort measure for soreness during prolonged prone paddling. A reader searching for gear may use the phrase “surfing wetsuit with chest padding.” No particular brand or product was tested or verified.
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Padding should not be presented as a treatment, a way to dissolve a mass, or a proven prevention method. If pressure causes pain, a surfer can discuss board fit, paddling position, session length and protective padding with a clinician and experienced coach. Stop or modify an activity that sharply increases pain, and have a changing lump assessed rather than trying to manage it solely with equipment.
Prognosis and the questions that remain open
The lesions in the report appeared clinically benign during the observations described. The authors nevertheless state that the risk of malignant transformation is unknown. That uncertainty reflects both the small sample and the fact that “liposurfoma” is a newly proposed term rather than a long-established disease category with extensive follow-up.
Continued surfing may be associated with persistence or additional enlargement in some cases, while prolonged inactivity was associated with slow diminution in limited reports. Those statements describe what clinicians observed in a few patients; they are not guarantees and do not establish a predictable timeline.
- No population-based prevalence estimate was identified.
- No controlled study proves that surfboard pressure causes the lesions.
- No study establishes cold water as a cause.
- No comparative trial shows whether observation, excision or liposuction is most effective.
- No validated test lets a surfer confirm the diagnosis without clinical assessment.
A practical decision checklist for surfers
- Notice the change: Record when the lump appeared and whether its size, firmness, mobility or tenderness changes.
- Consider exposure without assuming causation: Note whether symptoms track with long paddling sessions or improve during rest, but treat that pattern as information for a clinician, not a diagnosis.
- Book an examination: A new, enlarging, painful, fixed, recurrent or uncertain mass deserves professional assessment.
- Ask what the diagnosis is based on: Clarify whether the clinician is confident from examination alone or recommends further evaluation or tissue analysis.
- Discuss options: If the lesion is thought to be related to the proposed entity, ask about observation, excision and tumescent liposuction, including the limits of the available evidence.
- Manage pressure only for comfort: Padding or equipment changes may reduce soreness but should not replace evaluation or be described as treatment.
What to remember about the term
Liposurfoma currently describes a small cluster of acquired fibrolipomatous chest-wall growths reported in avid shortboard surfers. Repeated board pressure during prone paddling is the proposed association; cold water is not an established cause. Because the evidence consists of seven cases and earlier isolated reports, the safest response to a surfer’s new or changing lump is a clinical examination rather than self-diagnosis.
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