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Liposurfoma is a proposed medical term for an acquired fibrofatty lump that has been described along the chest wall of avid shortboard surfers. In a 2024 report, clinicians linked the masses to repeated pressure and minor trauma from lying prone on a surfboard while paddling.
Cold water is not established as the cause. The available evidence is a seven-patient case series, so it cannot show how common the condition is, prove that surfing causes it, or determine which treatment works best. A new, enlarging, painful, fixed, recurrent or uncertain lump should be examined by a qualified clinician rather than identified from surfing history alone.
What “liposurfoma” means
The word liposurfoma was proposed in a 2024 JAAD Case Reports article for acquired fibrolipomatous growths occurring at recurring surfboard-contact points. “Fibrolipomatous” means that a mass contains both mature fat and fibrous connective tissue. The reported lesions were subcutaneous, meaning they developed beneath the skin rather than in the skin itself.
The term is new and describes an observation in a small clinical series, not a universally established diagnosis with agreed diagnostic criteria. A person cannot confirm a liposurfoma simply because a lump appeared after surfing. Other benign and, less commonly, serious causes of a chest-wall mass can look similar.
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What the 2024 report actually found
Paytra A. Klein, Ronald J. Barr, Natasha A. Mesinkovska and Jeffrey A. Klein described seven surfers with masses in locations repeatedly pressed against a board during prone paddling. The article appeared online on January 26, 2024, and in volume 48 of JAAD Case Reports in June 2024, on pages 36–41.
| Finding in the report | What it tells us |
|---|---|
| Number of patients | Seven; this is a case-series count, not a prevalence estimate. |
| Typical location | Upper abdomen and anterior costal margin, matching repeated board-contact areas. |
| Histology | Sampled lesions contained mature fat and fibrous tissue; the authors considered the findings compatible with chronic trauma to subcutaneous fat. |
| Procedures described | Three patients had surgical removal with histologic examination, two had tumescent liposuction, and two chose no treatment. |
| Course described by the authors | Masses appeared to increase with more surfing and slowly diminish during prolonged inactivity in some reports. No quantified dose-response relationship was established. |
Because every participant came from a small clinical report, the findings do not establish an incidence, risk percentage or typical outcome for surfers generally. Earlier literature cited by the authors consisted largely of isolated reports, and the number of affected surfers remains unknown.
Is cold water responsible?
No. The report does not demonstrate a cold-water mechanism. The proposed association is mechanical: repeated, low-intensity compression while a surfer lies on the board and paddles. Cold conditions may be part of a surfer’s environment, but the case series did not compare cold- and warm-water surfers, measure tissue temperature, or show that cold exposure produces these growths.
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The authors’ biological explanation is also a hypothesis. Repeated microtrauma could trigger repair in subcutaneous tissue, with activity by fat cells and fibroblasts gradually producing a fibrofatty enlargement. The location of the reported masses makes that explanation plausible, but plausibility is not proof. There was no controlled experiment, population study or objective exposure threshold showing how much surfing would be required.
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Why the pressure hypothesis fits the reported locations
A shortboard surfer spends repeated sessions lying on the chest and upper abdomen. The same part of the torso can be compressed against the deck during paddling, especially where the body contacts the board’s rails or a raised section. A lesion developing at a consistent pressure point is therefore more compatible with the authors’ mechanical theory than with a general effect of cold water. That interpretation still remains an association drawn from seven cases.
What these masses may look and feel like
The reported growths were fatty or fibrofatty lumps under the skin of the chest or upper abdominal wall. They were located at repeated surfboard-contact points rather than described as a diffuse change across the entire torso. One case included a smaller tender nodule within a larger mass.
Symptoms can vary. A lump may be painless and noticed mainly because of its size or position, while pressure from paddling can make it sore. The case report does not provide a standardized symptom checklist, size range or reliable timeline that can be used for self-diagnosis. A mass that feels hard, is attached to deeper tissue, changes quickly or causes persistent pain needs professional assessment regardless of whether the person surfs.
Liposurfomas are not the same as “surfers’ knots”
The names sound similar, but the reported conditions are different.
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| Term | Typical description in the medical literature cited | How it differs from a proposed liposurfoma |
|---|---|---|
| Liposurfoma | Acquired fatty or fibrofatty masses on the chest wall or upper abdomen of avid shortboard surfers, at repeated board-contact points. | Subcutaneous fat and fibrous tissue are the central reported findings. |
| Surfers’ knots | Symmetric, rock-hard, dense, callus-like fibrotic masses on the lower extremities of longboard surfers. | They are lower-limb fibrotic callus-like lesions, not the chest-wall fatty growths proposed as liposurfomas. |
| Surfer’s bursa | A rare chest-wall mass mentioned as a separate entity in the differential diagnosis. | It is not interchangeable with liposurfoma and requires its own clinical evaluation. |
“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.”
How a clinician evaluates a surfer’s lump
The first step is an examination and a careful history, including when the lump appeared, whether it has changed, where the board contacts the body, and whether symptoms vary with surfing or rest. A clinician may also ask about prior injury, procedures, infection or other medical conditions. Those details help determine whether the lesion is likely superficial and benign or whether it needs further investigation.
The case series confirmed the nature of some lesions through tissue obtained at surgery or liposuction. That does not mean every lump requires removal. It does mean that a label based solely on location or a surfing history is inadequate when the diagnosis is uncertain. Imaging, a needle sample or complete excision may be considered by the treating clinician, depending on the examination and the features of the mass.
Seek medical assessment promptly when a lump is:
- New and continuing to enlarge.
- Painful, tender, inflamed or associated with skin changes.
- Fixed to deeper structures rather than freely mobile.
- Recurrent after it was removed.
- Unusually firm, irregular or otherwise unlike a typical soft fatty lump.
- Still unexplained after an initial examination.
These warning features do not prove cancer. They indicate that reassurance based on surfing exposure alone would be unsafe. The risk of malignant transformation for the proposed liposurfoma entity is unknown.
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Treatment options described in the report
The seven cases included observation, surgical excision and tumescent liposuction. No controlled comparison was performed, so the report cannot establish that one approach is more effective, safer or less likely to recur.
| Option | When it may enter the discussion | What the evidence does—and does not—show |
|---|---|---|
| Observation | A clinician has assessed the lesion and the patient has little discomfort or does not want a procedure. | Two patients in the report chose no treatment. There is no standardized schedule for follow-up or evidence defining long-term behavior. |
| Surgical excision | A mass is symptomatic, bothersome, diagnostically uncertain or preferred for removal after clinical discussion. | Three reported patients had excision with histology. The series supplies no success rate, recovery comparison or recurrence percentage. |
| Tumescent liposuction | A clinician considers removal of fatty tissue through a liposuction technique. | Two patients underwent the procedure. The report does not compare its completeness or durability with excision. |
Treatment decisions depend on the confirmed or suspected diagnosis, symptoms, size and position of the mass, the person’s goals and the clinician’s assessment. Continued pressure from surfing could matter if the mechanical hypothesis is correct, but the report does not establish a recurrence rate or prove that stopping surfing prevents a new lesion.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Can padding or a wetsuit prevent liposurfomas?
The authors mention a wetsuit with foam padding over the focal pressure area as a comfort measure for soreness during prolonged prone paddling. A search phrase such as “surfing wetsuit with chest padding” describes the type of gear a surfer might investigate, but no particular product was tested or verified.
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Padding should not be presented as treatment, prevention or a way to dissolve a growth. It may alter pressure and improve comfort, but there is no evidence that it changes the underlying tissue process. If padding itself creates a new pressure point, restricts movement or worsens pain, stop using it and ask a clinician or qualified surf professional about fit and technique.
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What is known about prognosis?
The reported lesions appeared clinically benign in the small series. Some observations suggested that they became more prominent with increased surfing and slowly diminished during extended inactivity. Those observations were not measured with a standardized protocol, so they cannot predict what will happen to an individual lump.
There is no established population prevalence, natural-history curve, malignant-transformation risk or evidence-based prevention plan for liposurfomas. The term itself was introduced only recently. A diagnosis should therefore be treated as a clinician’s working description supported by examination and, when needed, tissue evaluation—not as a permanent explanation for every chest-wall lump in a surfer.
Practical questions for a surf session and a medical visit
Before continuing to surf
- Note the lump’s approximate location and size so you can identify real change.
- Pay attention to whether pain occurs only during prone paddling or also at rest.
- Avoid repeatedly pressing directly on a painful or rapidly changing area until it has been assessed.
- Do not let temporary comfort from padding substitute for evaluation.
At the appointment
- Explain how often and how long you surf, your board type and where your body contacts the deck.
- Describe any increase during periods of heavy surfing or decrease during time away from the water.
- Bring information about prior injuries, operations or previous lumps in the same area.
- Ask what diagnosis is being considered, whether tissue confirmation is needed and what follow-up is appropriate.
The bottom line on liposurfomas
Liposurfoma is a proposed name for chest-wall fibrolipomatous growths reported in avid shortboard surfers. The best-supported connection is repeated surfboard pressure during prone paddling, not cold water. The evidence consists of seven cases, with no prevalence estimate and no treatment trial. Observation, excision and tumescent liposuction have all been described, while padding is discussed only for comfort. Any new, enlarging, painful, fixed or uncertain lump deserves an in-person clinical assessment.
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