A Family Doctor's Tale - LIPOMA

DOC I HAVE LIPOMA

Lipoma is usually a benign tumor of fat tissue.  Many patients have these swellings and are usually worried because the swelling becomes bigger with time.

Most wants the swellings to be removed while others are fearful of operations .

I have a taxi driver who has a lump of the size of a small water melon on one side of his neck .

In spite of my reassurances he refused to go for surgery.

Eventually I recommended him to a very well known surgeon and he finally had his operation done.


Lipoma is a benign tumor which consists of well circumscribed fatty tissue.



Lipoma is more common in women than in men.

A possible reason is that women has more fatty tissue than men.

Lipomas can also be found all over the body:
1.subcutaneous

2.subfascial

3.subsynovial

4.intrarticular

5.intramuscular

6.perosteal

7.subserous

8.submucous

9.extradural



Lipoma is a well encapsulated round swelling consisting fats cell which are not distinguishable from normal fat cells.

Possible causes are:

1.hereditary - more common in some families than others

2.injury to fatty tissue - stimulation for the fat cells to grow and accumulate at one site.



Symptoms :

1.slow growing round soft tissue swelling on the skin

2.multiple swellings may also be present.

3.painless

Signs:

1.swelling are well demarcated and rounded

2.Soft tissue felt on palpation.

3.May grow to considerable size.

Diagnosis of Lipoma is made based on:

1.round well encapsulated swelling

2.soft on palpation

3.Unlike sebaceous cyst doe not have an central blocked opening

4.Ultrasound may used to confirm the presence of fatty tissue and not a cyst or malignant tumor

5.Biopsy of the swelling will confirm presence of fat cells

Complications of Lipoma are:


The lipoma may grow to considerable size over time and can cause blockage to neighbouring organs:

1.intestinal obstruction at the abdominal area

2.difficulty in breathing especially near the trachea

3.In rare cases lipoma may become malignant liposarcoma



The only treatment is surgical excision of the lipoma.

Small lipomas may left alone if they are slow growing and does not impinge on the nearby organs.



The prognosis is usually excellent.

Recurrence at the same spot is rare but do occur due to regrowth of the blood vessel supplying the lipoma.

Rarely a lipoma may undergo malignant degeneration and become liposarcoma.