Multiple lipomas causes. Can a lipoma turn into cancer? Lipoma removal technique

Lipoma (wen, lipoblastoma, fatty tumor) is a benign neoplasm (tumor) that develops from adipose tissue.

Lipoma is more common in women in the 30 to 50 age group. This tumor can be located wherever adipose tissue is present: in the skin, tissue (subcutaneous, intermuscular, perirenal, retroperitoneal), mammary gland, lungs, mediastinum (anatomical space in the middle sections of the chest cavity, bounded in front by the sternum and behind by the spine), organs gastrointestinal tract, myocardium (the muscular middle layer of the heart, which makes up the bulk of its mass), the meninges, in the bones, along the large nerves. Very rarely, a lipoma can be located in the cranial cavity, uterus, liver.

Depending on the cellular composition of the lipoma, the following special types are distinguished:

Lipofibroma (soft lipoma, represented mainly by adipose tissue)
fibrolipoma (dense to the touch lipoma, consisting of adipose and connective fibrous tissue with a predominance of the latter)
angiolipoma (lipoma containing a large number of blood vessels)
myolipoma (fat containing smooth muscle fibers)
myelolipoma (a rare variety in which adipose tissue is mixed with hematopoietic, can be found in the tissue of the retroperitoneal space and pelvis, as well as the adrenal glands).

Causes of lipoma

The causes of lipomas are currently not reliably and definitively elucidated. Many scientists believe that the leading factor in the development of lipoma is a violation of embryogenesis (atypical fat cells of the subcutaneous adipose tissue laid down before the birth of a person). There is also an opinion that the occurrence of a lipoma may be associated with a systemic violation of metabolic (metabolic) processes occurring in adipose tissue. In addition, the possibility of the development of these tumors due to a violation of hormonal reactions in the body, which include the menopause in women, when there is a restructuring and extinction of the reproductive function, and damage to the hypothalamus (a part of the brain), which is responsible for all metabolic processes in the body, is not excluded. .

Diseases of the pancreas and liver, reduced function of the thyroid gland and pituitary gland (a brain appendage in the form of a rounded formation that produces hormones that affect growth, metabolism and reproductive function and is the central organ of the endocrine system) can stimulate the development of a lipoma.

Quite often, lipomas develop against the background of alcoholism, diabetes, malignant neoplasms of the upper respiratory tract. The medical literature describes familial cases with autosomal dominant inheritance of subcutaneous lipomas. The increase in the size of lipomas is not associated with the general condition of the patient's body: even when exhausted, they do not stop accumulating fat.

Lipoma symptoms

On examination, the subcutaneous lipoma is a rounded, mobile, painless formation that is not soldered to the surrounding tissues and skin. When the skin is stretched over the lipoma, retractions appear due to the lobular structure of this tumor. A lipoma is located where fatty tissue is present, most often under the skin. The characteristic localization sites of subcutaneous lipomas are the back, upper and lower limbs, the head (its scalp and face). Quite often, the lipoma is multiple.

The size of a lipoma can vary from the size of a pea to the size of a child's head, but is usually between 15 and 50 mm. There are also giant lipomas: in such patients, the tumor sags, forming a thin leg of skin at its base, which can lead to stagnation of blood, edema, necrosis and ulceration. Sometimes the size of the tumor is determined by the patient's body weight: with an increase in the patient's weight, the fatty tumor also increases in size, but more often its growth occurs uncontrollably, regardless of changes in body weight.

Usually, the formation has a soft, soft-elastic consistency, and with a pronounced development of connective tissue in it, its compaction occurs. In most cases, lipomas are asymptomatic, but sometimes they can be painful, cause discomfort, and also compress nearby organs. Patients mainly complain of a cosmetic defect, especially since the size of lipomas increases with age.

Lipomas of the retroperitoneal space can reach quite large sizes. Their clinical manifestations are due to displacement or compression (compression) of nearby organs.

Infiltrating, or intramural, lipoma is localized in the thickness of the muscles, while not having clear boundaries.

Multiple small lipomas located along the course of large nerves are sometimes painful due to pressure on the corresponding nerve. The diagnosis of deep-lying lipomas is quite difficult, it is possible to establish, as a rule, only with a histological examination.

Examination for lipoma

Diagnosis of superficially located lipomas is relatively simple and is based on their location, soft elastic consistency, mobility in relation to surrounding tissues, painlessness on palpation and the formation of characteristic retractions when the skin is stretched over this neoplasm.
In cases where the lipoma is located in places inaccessible to palpation (inside the chest, joint, in the spinal canal), it is necessary to use additional research methods: radiography and ultrasound (ultrasound).

1. X-ray diagnosis of soft tissue wen is based on the use of long-wave ("soft") X-ray radiation, which allows you to assess the structure of the soft tissues of the body. When radiography of lipomas that lie deep, for example, in muscle tissue, it is necessary to increase the "rigidity" of the X-ray beam. On the obtained radiographs, the lipoma has the appearance of enlightenment with smooth outlines, usually of the correct shape. Such an enlightenment formed by a lipoma is usually homogeneous, but occasionally small areas of calcification (deposits of calcium salts in the tissue) can occur in it. The form of such enlightenment depends on the density of the organs between which the wen is enclosed.

When a lipoma is located in the abdominal cavity, retroperitoneal space or chest, an X-ray examination is carried out using artificial gas contrasting (creation of pneumomediastinum, pneumorethroperitoneum, etc.).

2. The most reliable method for diagnosing deep-lying lipomas is X-ray computed tomography (CT), which makes it possible to clearly distinguish adipose tissue, which is characterized by a low rate of absorption of X-ray radiation, from denser soft tissue structures.

3. In ultrasound examination (ultrasound), lipomas look like hypoechoic formations with a thin capsule, located in the thickness of adipose tissue.

4. If there is doubt about the benign nature of the tumor, a puncture (fine-needle) aspiration biopsy is used, followed by a cytological examination: a fragment of the neoplasm is taken with a thin needle, and then the resulting biological material is examined under a microscope.

Laboratory examination:

Laboratory examination for lipoma has no independent value for making a diagnosis. In case of hospitalization to perform a planned surgical intervention for a lipoma, a general clinical laboratory examination (complete blood count (CBC), urinalysis (CAM), biochemical blood test (BAC), blood glucose, HIV, syphilis, hepatitis) is performed, which allows exclude contraindications to surgical intervention.

In doubtful cases, to exclude other diseases, a cytological examination of the material obtained from a puncture biopsy is performed. For this purpose, the material obtained by puncture is applied to glass slides, which are then stained according to the Romanovsky-Giemsa method. Ready preparations are examined by a cytologist under a microscope. With a lipoma in a smear, ordinary fat cells (adipocytes) are found, between which groups of cells containing several fat vacuoles are found.

Treatment of lipomas

Treatment of lipoma is only surgical. There are the following indications for surgical treatment of lipomas:

1. A rapidly progressive increase in the size of the lipoma;
2. Large size of lipoma;
3. Functional disorders, manifested by compression of surrounding organs and tissues; soreness of the lipoma, dysfunction of the organ;
4. Cosmetic defect.

For small tumors with an accessible location, surgery is performed under local anesthesia in an outpatient (polyclinic) setting. With large lipomas, as well as lipomas localized in complex anatomical areas (for example, lipomas of the neck, axillary fossa), patients are hospitalized, and surgical treatment is performed in a surgical hospital.

With lipomas, there are three options for surgical intervention:

1. Lipoma excision with capsule- is the most radical method of surgical treatment. Under local anesthesia with a wide skin incision, the lipoma is exfoliated and removed along with the capsule, after which sutures are applied to the subcutaneous fatty tissue and skin. In the case of a large neoplasm, drainage is placed in the bed of the removed lipoma for one or two days. The advantage of this surgical technique is the high radicality and the absence of neoplasm relapses, and the disadvantage is the unsatisfactory cosmetic effect.

2. Minimally invasive (endoscopic) lipoma removal: through a small skin incision up to 1 cm long, the lipoma is destroyed and removed inside the capsule, the completeness of the removal is controlled using a miniendoscope (an optical device used to study hollow anatomical formations). Such a surgical intervention allows to achieve a good cosmetic effect, but is not radical enough.

Endoscopic removal of lipoma: 1 - lipoma; 2 - lipoma capsule; 3 - optical tube; 4 - video camera; 5 - working tool; 6 - light guide.

3. through a skin incision no more than 5 mm in length, the lipoma is removed inside the capsule using a lipoaspirator without subsequent verification of the completeness of its removal. Despite the best cosmetic effect, this surgical technique is fraught with a high probability of lipoma recurrence.

Lipoma liposuction: 1 - lipoma; 2 - lipoma capsule; 3 - deep tissues; 4 - skin; 5 - subcutaneous tissue; 6 - suction tube.

Complications of lipoma

It should be noted that complications of the wen are very rare.

1. Inflammation. The tumor turns red, increases in volume, becomes painful. When pressing on the wen, fluctuation (transmission waves) is felt, that is, the presence of fluid in the tumor.
2. In exceptional cases, a wen can degenerate into a malignant tumor (liposarcoma).
3. Large, long-term lipomas cause displacement of surrounding tissues. For example, a peripheral nerve lipoma can cause pain, and if it is located in the preperitoneal tissue, it can contribute to the occurrence of a hernia of the white line of the abdomen.

Prevention of lipomas

There are no specific preventive measures that can affect the causes of lipoma.

Forecast

Lipoma can remain unchanged for a long time or very slowly increase in size. Under the influence of trauma or for no apparent reason, the lipoma can become malignant - acquire the character of a malignant neoplasm (liposarcoma) with germination into nearby tissues.
Treatment prognosis for lipomas is usually favorable, although lipomas can recur both at the surgical site if not all pathological fat cells have been removed, and at a new site.

Surgeon Kletkin M.E.

Lipoma (wen) is a benign tumor that develops in adipose tissue. The tumor often does not have clear boundaries, looks like single or multiple nodes. Affecting intermuscular connective tissue, lipoma can lead to muscle atrophy.

Causes of the appearance of wen (lipomas)

Reliable causes of lipomas have not been finally clarified, the most likely factors of their formation are:

• Hormonal disorders in the body.
• Diseases of the thyroid gland, liver.
• Violation of metabolic processes in adipose tissue.
• Non-observance of personal hygiene.
• Soft tissue injuries.
• Poor quality food.
• genetic predisposition.

Signs of lipomas

A newly appeared small lipoma is often discovered by chance, since the neoplasm is painless and does not manifest itself for a long time. Patients experience discomfort only when touching lipomas located along the nerve trunks.

Wen can be 1-20 cm in diameter, sometimes more. When palpated, these are subcutaneous formations of medium density, surrounded by a connective tissue capsule, mobile, not soldered to neighboring tissues. The skin over the wen can be easily displaced in all directions.

Most often, lipoma is diagnosed in women aged 30 to 50 years. Wen can appear wherever there is adipose tissue: on the face, scalp, back, legs or arms, mammary glands, intermuscular fascia. Rarely, lipomas affect the gastrointestinal tract, liver, tendon sheaths of the joints.

Wen never appear on the feet and palms.

Over time, lipomas increase in size, and when squeezing nearby organs, they can cause discomfort. Also, a feature of lipomas is that with a decrease in the patient's body weight, lipomas do not decrease, but, on the contrary, sometimes increase.

Hereditary predisposition is the cause of multiple lipomatosis - increased fat deposition in the intermuscular spaces and subcutaneous tissue. Wen at the same time are localized throughout the body, almost without affecting the head, shoulders and legs below the knees; their number can reach fifty pieces.

According to the structure and localization, the following types of lipomas are distinguished:

• Lipofibromas are soft to the touch formations, consisting only of adipose tissue.
• Fibrolipomas - a little denser to the touch, consist of adipose and connective tissues. This type of lipoma appears on the thighs, calves.
• Myolipomas are dense formations, their structure includes smooth muscle fibers.
• Angiolipomas - consist of muscle, fatty tissues and thick-walled blood vessels. This type of lipoma affects the internal organs: liver, kidneys.
• Myelolipomas are formed by adipose and hematopoietic tissues. Rarely found in practice, more often affect the adrenal glands.

Diagnostics

Superficial lipomas can be easily recognized by a specialist; those located in the internal organs are difficult to detect.

Lipoma is often confused with atheroma; only a doctor can distinguish between them. Atheroma is a cyst of the sebaceous gland of the skin, it occurs in case of clogging of its excretory duct. Inside the atheroma are drops of fat; formations often become inflamed and suppurate.

Differences between atheroma and lipoma:

• Atheroma is located in the connective tissue of the skin (dermis), while lipoma is a subcutaneous formation.
• Atheromas are formed only on the sebaceous glands, so they rarely occur on the legs, arms, and mammary glands.
• Atheroma does not apply to tumors.

For the treatment of atheroma, a surgical method, laser photocoagulation, laser excision with a shell, and laser evaporation of the cyst shell from the inside are used.

In addition to atheroma, lipoma should be distinguished from such formations:

• Hygroma - accumulation of fluid in the cavity of the periarticular bag.
• Lymphadenitis is an inflammation of the lymph nodes.
• A dermoid cyst is a benign formation caused by improper tissue fusion due to a malformation of the organism at the prenatal stage.
• Malignant tumors.

For the diagnosis of wen, inaccessible to the doctor for probing, X-ray, ultrasound and X-ray computed tomography are used. If a malignant lipoma is suspected, the method of puncture aspiration biopsy is used, when a fragment of a wen is taken with a thin needle and examined under a microscope.

Why are lipomas dangerous?

Small bugs pose no danger. If they are found, it is necessary, just in case, to contact an oncologist to clarify the diagnosis. If the lipoma does not interfere, it can not be removed. Most often, women seek to get rid of wen due to cosmetic defects caused by neoplasms.

But there are cases when getting rid of lipomas is necessary:

• The rapid growth of the wen, soreness when pressed on it.
• Restriction of movements in periarticular localization.
• Lipoma compression of blood vessels or nerves.

These conditions can cause pathological changes in the tissues located near the lipoma, so the help of a doctor is needed here.

Very rarely, wen can degenerate into a malignant tumor - liposarcoma. This occurs with a long course of the disease, when the lipoma reaches a large size or is often injured.

Treatment of wen (lipomas)

Treating lipomas on your own using folk methods, and even more so trying to squeeze them out, is pointless, sometimes dangerous: some aggressive remedies included in traditional medicine recipes (iodine, garlic) can provoke inflammation. Wen are removed only surgically - this is an effective and safe method of getting rid of neoplasms. There are no drugs to treat them.

Careful attention should be paid to lipomas found in children. Until the age of five, doctors do not recommend removing wen, at an older age, if discomfort, growth, cosmetic defects occur, lipomas are removed.

To remove small wen (up to 3 cm in diameter), a special preparation is used to promote their resorption.

Wens with a diameter of up to 7 cm are removed in outpatient settings, larger tumors require surgical intervention in a surgical hospital.

There are three methods of surgical removal of lipomas:

• Surgical excision - the lipoma is removed along with the capsule through a wide skin incision. The advantage of the method is the complete removal of the wen and the absence of re-growth. The disadvantage is that there are noticeable scars after the operation.
• Endoscopic removal - an incision of no more than 1 cm is made on the skin, through which the lipoma is destroyed and removed. The operation is controlled with the help of a mini-endoscope. This method gives a good cosmetic effect, but does not exclude the possibility of relapse.
• Liposuction of a lipoma - through an incision about 5 mm in size, a lipoaspirator tube is inserted, with the help of which the fatty tissue of the lipoma is sucked off. When using this method, the best cosmetic effect is achieved, but due to the lack of control over the completeness of the removal of the wen, the likelihood of its re-growth is high.

After the end of the operation, the removed tumor must be sent for histological analysis to exclude oncological cell degeneration. Postoperative sutures are treated with 70% ethyl alcohol and covered with a protective bandage. When large lipomas are removed, serous fluid accumulates in the cavities formed in place of the wen: for its outflow, drainage tubes are placed.

Occasionally, patients may develop a fever. If the rules for processing seams are violated, a bacterial infection may join. In this case, the doctor will prescribe antipyretic drugs and antibiotics.

To accelerate the resorption of postoperative scars, it is recommended to use Contractubex gel or other scar removal agents.

Prevention of lipomas

Effective scientifically proven preventive measures that prevent the development of lipomas have not been found. To reduce the risk of wen, you should follow the hygiene of the skin, lead an active lifestyle, avoid injuries and hypothermia, and eat right.

If any neoplasms appear on the skin, you should immediately consult a doctor so as not to miss the development of a serious disease.

Lipoma, wen or fatty tumor are all names for the same phenomenon. Tumors of this type usually appear in the body, on the neck, in the armpits, in the shoulders and hips, and in the internal organs. Fortunately, most often a lipoma is not life-threatening. However, it's best to be prepared ahead of time and understand what you're (maybe) dealing with. If you are looking for information on how to identify the symptoms of lipoma or how to treat this disease, go to the first paragraph of the article.

Steps

Identifying Symptoms

Look for small bumps under the skin. The lipoma is usually dome-shaped and comes in various sizes (from the size of a pea to three centimeters in length). These tumors are formed due to the increased formation of fat cells in a particular place.

Understand the difference between a lipoma and a cyst. The cyst has clearer boundaries and shape, it is more solid compared to the lipoma. The bump formed by the lipoma usually does not exceed three centimeters in length. The cyst may be larger than 3 cm.

Check how soft this bump is. Lipoma tumors are usually quite soft to the touch - they give in if you press on them with your fingers. These tumors are very loosely attached to the surrounding tissues, and although they remain relatively in place, they can be moved slightly under the surface of the skin.

Notice if you are in pain. Although fatty tumors are usually painless (they have no nerve endings), they can sometimes cause pain if they grow in the wrong place on the body. If a lipoma occurs near a nerve, as it grows, it can begin to put pressure on it, which causes pain. Talk to your doctor if you have pain in the area of ​​the lipoma.

Try linseed oil. Flaxseed oil is saturated with omega-3 acids. These acids dissolve the fat formed in the tumor, and also stop the further growth of fat cells. You should apply flaxseed oil directly to the affected area three times a day for the treatment to have a positive effect.

Drink more green tea. Green tea contains substances that have anti-inflammatory properties, which also help to reduce the amount of adipose tissue in the body. Anti-inflammatory properties have an indirect effect on the tumor, reducing its size. If you drink a cup of green tea a day, you can get rid of the tumor, or at least make it less noticeable.

Increase your turmeric intake. This Indian spice is rich in antioxidants that help stop inflammation and the production of tumor fat cells. Mix olive oil and turmeric (a teaspoon of each) and apply to the wen every day. Repeat this procedure until the tumor is completely gone.

It is a benign tumor whose histological substrate is white adipose tissue. This tumor is characterized by slow, painless growth. Its degeneration into malignant liposarcoma almost never occurs. Theoretically, it can develop in any part of the body, with the exception of the palms and feet. Superficial subcutaneous lipomas, also called wen, develop in approximately 95% of all tumors of this type. The remaining 5% are in the abdominal and thoracic organs, bones, muscles, brain and spinal cord. Multiple damage to the body by these tumors is called lipomatosis.


One of the varieties of lipomas is hibernoma - a tumor of their embryonic rudiments of brown fat. Outwardly and clinically, it differs little from the classic lipoma and is distinguishable only after a histological examination. For this reason, in the future, hibernomas will be described together with lipomas.

Drug treatment of these tumors today brings more side effects than benefits, so we can say with confidence that it does not exist at all. In most cases, these tumors do not cause any inconvenience to their carriers, except for an unpleasant aesthetic appearance. Therefore, they can remain untreated throughout their lives.

The preferred treatment for a lipoma is surgical removal. As a rule, this happens in rare cases, when the lipoma is complicated by the infringement of nerves and blood vessels, which leads to chronic pain. Removal of the tumor in this case is arbitrary and is determined by the will of the patient. Less often, there are situations in which lipomas can be operated on without fail, since they carry a direct threat to the patient's life.

The mechanism of formation of lipomas

The first mechanism is the most recognized in the world and is confirmed by numerous studies in this field. It consists in the growth of a lipoma like a tumor. In other words, the fat cells that make up this formation are clones of one cambial cell, from which the entire population subsequently appears. This theory is supported by the lobular structure of most deep lipomas, as well as the detection in them of specialized cells with a high mitotic ( cellular) activity.

The second mechanism for the formation of lipomas is associated with a violation of the outflow of the secretion of the sebaceous glands and, as a result, the accumulation of adipose tissue in the enlarged lumen of the gland itself. Such lipomas are often located superficially and do not have a lobed structure. Their most frequent localization in places of accumulation of the sebaceous glands, which also testifies in favor of this mechanism.

Causes of lipomas

The reasons for the formation of lipomas are:

• genetic predisposition;
• violation of fat metabolism;
• violation of the mechanism of reverse regulation of fat formation;
• low level of personal hygiene;

genetic predisposition

Violation of fat metabolism

Violation of fat metabolism is clinically manifested by an increase in the blood of a special fraction of fats - low density lipoproteins. Since these fats cannot freely seep into the gaps between the cells of the inner layer of blood vessels ( endothelium), they clog them. After a significant part of the endothelium is impermeable to fats, the absorption of other fractions also deteriorates. As a result, the blood becomes "fatty", and blood lipids are deposited in the vessels, forming atherosclerotic plaques. Settling in the liver, fats penetrate into all its sinuses, provoking the development of such a pathology as fatty hepatosis. In narrow capillaries, fat deposits become so pronounced that they clog their lumen. Clinically, this does not manifest itself in any way, since a large network of collaterals is formed at the level of the capillaries, which replenishes the blood supply to the affected tissue area. However, fat deposits in this place begin to grow. Over time, a connective tissue capsule appears with numerous partitions, due to which the illusion of a lobular structure of the lipoma is created.

The reason for the increase in low-density lipoproteins in the blood can be both a sedentary lifestyle and excessive consumption of animal products, as well as genetic diseases. These diseases are the lack or impossibility of production in the body of certain enzymes that break down fats.

Violation of the mechanism of inverse regulation of fat metabolism

Such a mechanism is extremely useful because it is autonomous, that is, it does not require hormonal or any other control. It does not prevent the consumption of adipose tissue during prolonged fasting and ensures the restoration of the usefulness of subcutaneous fat during a period of adequate nutrition. During overeating, this mechanism prevents the deposition of fat and removes excess fat from the body through urine and bile. It is for this reason that some individuals in whom this system functions successfully never gain weight, no matter how they eat.

However, it happens that this mechanism fails. In some cases, its violation extends to the entire body, in others - only to certain areas of tissues. The cause can be severe stress, trauma, burns, frostbite, radiation exposure, etc. In the first case, the so-called neurogenic obesity occurs. In the second case, adipose tissue is deposited in limited areas of the tissue, forming lipomas. Their lobular structure corresponds to the structure of adipose tissue in other parts of the body.

Poor personal hygiene

What do lipomas look like?

trunk lipoma

In rare cases, the lipoma may be located above the spine. In this case, it is necessary to produce magnetic resonance imaging ( MRI) of this area to exclude the diagnosis of spinal hernia.

Lipoma of the thighs and forearms

The second situation in which pain may occur with lipoma of the forearms and thighs is the germination of this tumor by small vessels. In this case, the lipoma becomes an angiolipoma. The more vessels in this tumor, the more pronounced will be the pain on palpation. In no case can angiolipoma be considered one of the stages of malignant degeneration of a fatty benign tumor. Its cells are as highly differentiated as the cells of the lipoma, which indicates the preservation of its benign character.

Lipoma of parenchymal organs

Head lipoma

Several cases of intracranial growth of these tumors have been described in the medical literature. When describing the clinic of such lipomas, it is important to note that sometimes they can disguise themselves as very diverse diseases. Depending on the location of the tumor, various symptoms of it were manifested, both positive and symptoms of loss of certain functions.

Positive symptoms often appear with the growth of a tumor from one of the meninges and constant irritation of the corresponding parts of the brain. In this case, the most possible positive symptoms can be visual, auditory, olfactory hallucinations, involuntary movements of various parts of the body, disinhibition ( cheeky, cheeky) behavior, delusional thinking, etc. Symptoms of the loss of certain functions can be observed with its intracerebral growth. For example, when a tumor compresses the optic chiasm or one of the optic nerves, a clinic of loss of the corresponding visual field appears. With the development of a tumor from the pituitary gland, compression of all nuclei will gradually occur, and a decrease in the concentration of tropic hormones will be observed with the manifestation of the clinic of the corresponding endocrine disease.

With the growth of a lipoma in the lumen of the ventricles of the brain, over time, a violation of the circulation of cerebrospinal fluid may occur. In adults, this is manifested by severe headaches. In children and newborn babies, such a tumor can cause mental retardation. Intrauterine blockage by a tumor of the channels through which cerebrospinal fluid circulates can lead to the birth of a child with varying degrees of hydrocephalus and an unfavorable life prognosis.

Neck lipoma

Breast lipoma

Heart lipoma

Lipoma diagnostics

Instrumental studies in the diagnosis of these tumors are made only in the case of a clinical picture mixed with other more dangerous diseases. Often used ultrasound allows you to determine the structure of the formation, its exact dimensions, depth, and sometimes even the connection with surrounding tissues. When a lipoma is located under the capsule of a parenchymal organ, using ultrasound, only measuring its size and determining its structure is available.

In order to exclude hepatocarcinoma and clear cell kidney cancer, tests are performed to determine the corresponding tumor markers. The exclusion of an echinococcal cyst is technically more difficult and requires more expensive studies, such as computed tomography ( preferably combined with vascular contrast) and magnetic resonance imaging.

Computed tomography allows you to assess the size of the tumor, its contents, connection with surrounding organs, and even approximately estimate the density of the tumor and suggest what substance it consists of. Vascular contrast can be used to determine how vascularized a tumor is. One of the signs of a malignant tumor is a high concentration of blood vessels in it. Lipoma is a benign tumor and does not contain blood vessels, but an angiolipoma may contain them, which complicates the diagnostic process.

Magnetic resonance imaging is the most accurate study that exists today. Its advantages include a clearer visualization of soft tissues, the ability to assess the reaction of regional lymph nodes, absolute harmlessness to the patient, etc.

Which doctor should I contact?

With deep lipomas, patients complain of pain in the projection of the organs on which the tumor exerts pressure. Accordingly, first of all, the patient should seek advice from a local doctor, general practitioner, gastrologist, hepatologist, nephrologist and surgeon.

Is a biopsy and morphological examination of a lipoma necessary?

Morphological examination of the tumor is absolutely necessary, since it is the only method for accurately determining its nature. In tumor diagnostic protocols, morphological examination is the gold standard. However, more often it is performed after removal of the tumor in order to finally confirm the diagnosis. If the tumor is benign, the treatment ends there. If the tumor is malignant, then without fail, based on its type, it is necessary to undergo several courses of radiation therapy or chemotherapy to destroy the remaining tumor cells in the body.

Otherwise, the situation is with a biopsy. Among surgeons, there is some disagreement regarding the advisability of performing this diagnostic procedure. Moreover, the reason for the disagreement lies not in the methodology for performing the procedure or indications for it, but in the organization of the coherence of the work of the laboratory and the hospital. In other words, it is extremely important that no more than one day pass from the moment the biopsy is taken to the result.

A biopsy involves the removal of a specific part of the tumor. After removal, a small open wound remains, into which tumor cells enter and are carried by blood flow throughout the body. If the tumor is benign, then the spread of its cells does no harm. If the tumor is malignant, then every hour more and more cancer cells spread throughout the body, increasing the likelihood of metastasis growth after surgical removal of the main focus. Therefore, in advanced clinics, a biopsy is performed immediately before the operation and its result is reported to the surgeon within a few hours. Based on the result, the surgeon decides whether to operate on the patient and, if so, how large the volume of the operation should be. This scheme is the most correct in terms of the methodology of oncosurgery.

In more remote hospitals, where biopsy specimens must be sent to large medical centers, the time to obtain results increases significantly and sometimes reaches 1 to 2 weeks. Under such conditions, it makes no sense to wait for the result of a biopsy, since during this time it is practically guaranteed that the tumor will spread throughout the body and the patient will have no hope of recovery. It turns out that a biopsy performed before the operation does not make any sense. Thus, not being able to quickly determine the nature of the tumor, surgeons are forced to operate on patients "with a margin", that is, by removing more tissue than the tumor itself, in order to minimize the number of its residual cells. In addition to this, operating doctors remove regional lymph nodes, even if the latter do not show signs of inflammation. Then the tumor itself or part of it is sent for histological examination, the results of which determine the tactics of further actions. This method is more traumatic for the patient, but its effectiveness is equal to the first.

Treatment of lipomas

Is there an effective drug treatment for lipomas?

When is lipoma surgery necessary?

Relative indications for removal of a lipoma are:

• nerve compression and constant pain caused by this;
• localization under the capsule of the parenchymal organ;
• permanent trauma to the tumor;
• obstruction of the inflow or outflow of blood to a certain part of the body.

Absolute indications for the removal of a lipoma are:

• intracranial lipoma, squeezing the vital structures of the brain;
• the threat of lipoma rupture into the abdominal cavity or retroperitoneal space;
• lipoma that prevents the circulation of cerebrospinal fluid;
• intracardiac lipoma with severe heart failure, arrhythmias or blockade.

Lipoma removal technique

Before the operation, a test for allergic tolerance of the anesthetic substance is carried out. If the test is positive, the drug used should be changed or even the type of anesthesia should be reviewed. In addition, a single dose of a broad-spectrum antibiotic is performed to prevent postoperative complications. Shaving of the surgical field is carried out without the use of soaps and shaving products, that is, on dry skin. This detail is extremely important because it prevents skin irritation after shaving, and skin irritation with the appearance of at least one abscess is a direct indication for postponing the operation.

After placing the patient on the operating table in a position in which access to the lipoma will be possible at least from two sides, the surgical field is limited and treated alternately with alcohol and iodine solutions. At this time, the anesthesiologist performs anesthesia. The first incision is made only after the quality of anesthesia is considered satisfactory. Layer-by-layer dissection of tissues is carried out. In the vicinity of the capsule, they work mainly with the back, blunt side of the scalpel and clamps in order to maintain its integrity. As a rule, the lipoma capsule is easily separated and only in a few places is tightly soldered to the surrounding tissues. After removing the lipoma together with the capsule, the wound is treated with antiseptics and sutured in layers, preserving the topography of the tissues. A drain is left in the wound, through which the ichor is separated in the first few days after the operation. In the presence of signs of successful wound healing, the drain is removed. The stitches are removed at the end of the second week. Full recovery of working capacity occurs on average in a month.

Complications during the operation may occur when the capsule was initially deformed and the adipose tissue broke into the surrounding space. Over time, it infiltrated the nearby muscles and tendons, surrounded the vessels and nerves. When opening such a lipoma, visibility is very limited, and the vessels, nerves, muscles and tendons are connected into one knot through numerous adhesions. Under such conditions, it is extremely easy to accidentally cut a nerve or blood vessel with the development of corresponding complications. In addition, even after perfect cleaning of the wound and complete removal of adipose tissue, there is a high probability that after a certain time a lipoma will form again in the same place. This is due to the fact that a small part of the cells remained between the fibers of the tendons and muscles and resumed tumor growth.

Prevention of lipomas

In addition, there is a group of drugs called statins, which is designed to reduce the concentration of fatty fractions in the blood and thus prevent the complications of atherosclerosis. The best known drugs in this group are simvastatin and atorvastatin. It is believed that they can indirectly prevent the formation of lipomas or slow down their growth, but there is no scientific evidence for this hypothesis. Self-administration of these drugs can lead to irreversible metabolic disorders, so it is highly recommended to consult with your family doctor regarding the appropriateness of their use.

An important role is played by the protection of the skin and the glands located in it from the effects of various adverse factors, such as trauma, hypothermia, thermal and chemical burns, etc. Skin hygiene is also important, since it reduces the likelihood of boils, from which lipomas can subsequently form.

The disease is one of the common non-cancerous conditions that is formed from adipose tissue cells. Usually, these subcutaneous tumors are harmless because they are localized only in one area and do not spread to other parts of the body. A lipoma looks like a bump under the skin and can be single or multiple.

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Lipoma Risks

can occur in people of any age under certain circumstances. However, more often formed:

• in women over the age of 40 and especially in those over 50;
• in females, single lipomas predominate, in men - multiple;
• genetic conditions influence the occurrence of a tumor.

Causes

During early childhood and puberty, cells divide very rapidly. However, in adulthood, new cells are formed only when they are needed by the body to replace old or injured tissues. Unfortunately, the division process can take on unhealthy conditions:

• new elements can succumb to mutations, resulting in uncontrolled division;
• when fat cells become abnormal, they begin to accumulate in some place;
• as the abnormal fat cells grow, they begin to reproduce thousands of copies of themselves;
• the cells responsible for fat in the lipoma cease to function and divert resources from their energy purpose, starting to form tumors.

Signs and symptoms of lipoma

It is characterized as a soft subcutaneous seal of any size. Usually grows gradually. Education has the following features:

• it is surrounded by a thin white capsule that separates the tumor from the surrounding adipose tissue;
• usually occurs on only one side of the body;
• more common in the hips, back, neck and shoulder;
• sometimes formed in the soft tissues of the arms and legs, the brain, the heart, the wall of the digestive tract, inside the muscle tissue, or the spinal cord;
• these are usually not painful or itchy, except for those containing blood vessels, muscles, and other cell types;
• sometimes associated with a form of obesity, especially in middle-aged women;
• if the lipoma is located in the chest, pressure on the internal organs may occur and, accordingly, specific discomfort may occur.

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Can a lipoma be malignant?

Lipoma as a precancerous condition

Lipoma is never characterized by specialists as a fight. But formations located on the back of the neck (as if in place of the collar) or the abdominal space sometimes have a capsule that extends under the skin. It is this type of lipoma that can degenerate into cancer. If you find any atypical seal, you should immediately consult a doctor.

Also, incorrect diagnostic studies are often misleading and do not reliably establish the structure of the adipose tissue of the tumor. Cancer is represented by liposarcoma, which is of 4 types:

1. Highly differentiated, similar to normal fat cells and growing slowly.
2. Differentiated, has a low degree of malignancy.
3. Myxoid is an intermediate form to aggressive liposarcoma. Cells already have significant differences.
4. Pleomorphic - a rare subtype with cells very different from ordinary ones.

Modern treatment of lipoma

Education does not need therapy. However, sometimes it causes cosmetic discomfort, increases in size, becomes painful, interferes with movement, etc. In such cases, it is recommended:

1. Surgery is the most reliable way to treat lipomas with the least chance of recurrence.
2. Steroid injections. They reduce swelling but do not eliminate it.
3. Liposuction is the removal of fat from a tumor. The method is not able to completely get rid of the tumor.

The patient's condition after removal of the lipoma

after lipoma removal some complications may occur, such as:

• excessive bleeding;
• wound infection;
• subcutaneous collection of fluid (seroma) or blood (hematoma).

• keep the postoperative surface clean;
• change bandages regularly;
• take medicines prescribed by a doctor;
• avoid physical activity for about a month so as not to provoke bleeding;
• refrain from taking hot baths.

People who have repeatedly developed lipomas should take their health seriously and undergo regular examinations, since they guarantee a completely negative answer to the question: “ Can a lipoma turn into cancer?? oncologists are not accepted.