Lipoma Surgery in Hyderabad

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Lipoma is a benign tumor, composed of cells of adipose tissue (adipocytes), which accumulate inside a fibrous capsule just below the skin, in the subcutaneous tissue. Some people refer to them as "fat balls". Lipomas can appear in any region of the body, but preferably appear in the trunk, shoulders, in the posterior region of the neck and armpits. There are rare cases of deeper lesions, which are found in the muscles and nerves, in internal organs or in the abdominal cavity. In general, they measure no more than 2 cm or 3 cm, although some can increase in size and reach more than 10 cm in diameter.

Rounded in appearance, regular edges, firm and elastic consistency, slow growth and almost always painless, lipomas are small, soft nodules that move as if they were loose under the skin, when lightly pressed. Although there are several types, the most common is the superficial subcutaneous lipoma, consisting of a single lesion installed just below the surface of the skin.

Lipomas can appear at any age. However, they are uncommon in childhood and adolescence and more frequent in women between 40 and 60 years old.

CAUSES

The causes of lipoma are not known. Apparently, genetic components are involved in its development, given that it is common for the condition to affect people in the same family.

Some medical currents argue that the origin of the lipoma may be correlated with a trauma suffered in the region of the body where the injury was manifested (post-traumatic lipoma). This hypothesis has not yet been sufficiently proven. There is also no consensus regarding the relationship between obesity and lipoma formation. Anyway, it seems certain that thin people who gain weight quickly, are more subject to the formation of these masses of fat in the body, which do not regress with weight loss.

Not knowing the causes of lipomas makes it very difficult to develop preventive measures to control the disease.

RISK FACTORS

In addition to the risk factors already mentioned - age, genetic inheritance and female sex - some rare syndromes may be correlated with the appearance of multiple lipomas in different regions of the body. Among them, it is worth mentioning:

• Bannayan-Riley-Ruvalcaba syndrome;
• Madelung's syndrome;
• Painful adipose or Dercum syndrome;
• Cowden's syndrome;
• Gardner's syndrome.

SYMPTOMS

In general, lipomas are asymptomatic. Depending on its location, however, pain in the area affected by the lipoma is the most characteristic sign of the disease. In general, it arises when a neighboring structure (a nerve, for example) is pressured by the growth of the tumor.

DIAGNOSIS

At first, the diagnosis of lipomas is clinical, palpating the fat mass. However, under certain circumstances, biopsy performed on a sample of cells taken from the lesion for histopathological analysis, as well as computed tomography and magnetic resonance imaging are important tests to determine the type of the tumor and the differential diagnosis with sebaceous cysts and some neoplasms of the soft parts. The main concern is to exclude the presence of liposarcoma, a malignant tumor of adipose tissue that, in general, presents itself as a single hardened nodule, with irregular edges, low mobility and very rapid growth.

In the medical literature, however, there are very few records of benign lipomas that have evolved into malignant tumors. The certainty of this diagnosis, however, is only possible after performing histopathological analysis of cells.

TREATMENT

In general, small and painless lipomas do not require treatment, not least because they usually disappear spontaneously in a significant part of cases. However, treatment is indicated in the following situations:

• The lesions are painful or their location is too uncomfortable;
• They represent aesthetic or functional impairment;
• They grow rapidly;
• They leave doubts about his benign character.

There is no oral treatment. Steroid injections and liposuction of the adipose tissue are possible therapeutic approaches that can offer good results. In most cases, however, surgical lipoma extraction is the most used procedure. If, on the one hand, it has the inconvenience of leaving scars, on the other, it can be performed under local anesthesia, without the need for hospitalization. Another advantage is that the recurrence of the lesion practically does not exist, as long as it is removed completely together with the fibrous capsule.

• See a doctor - dermatologist, general practitioner or surgeon - for diagnosis, if you notice the growth of one or more nodules in any part of the body;
• Maintain periodic contact with your doctor, to perform routine clinical monitoring of lipomas already installed;
• Do not self-medicate or go after conversations by people who claim to be knowledgeable in the subject;
• Inquire about the availability of the health plan to bear the costs of the surgical procedure for removing the lipoma, if it is considered merely aesthetic.

Lipoma is a benign nodule caused by the excessive development of fat cells. Lipomas are usually located on the trunk, neck, thighs or arms, but can be located in any region of the body. Although they are harmless, it is essential that they are evaluated by the doctor for a differential diagnosis in relation to malignant, rarer situations, especially when they increase in size or give symptoms.

What are the characteristics of a lipoma?

“Lipomas are small tumors of more or less organized fat and do not represent any vital risk to the patient”, explains general surgeon Lioma Surgery clinic in Hyderabad, who points out the characteristics that help to distinguish other types of nodules:

• They usually have a smooth and regular surface;
• They can be firm or soft;
• As a rule, they are located immediately under the skin and move slightly when they touch;
• They usually have small dimensions (up to 5 centimeters);
• They are more frequent in the neck (cervical region), in the trunk and in the proximal region of the limbs (thighs and arms).

Although these characteristics are the most frequent, lipomas can also have larger dimensions (more than 10 or 15 centimeters) and / or a deeper location. “There are deep lipomas, which are inside the muscle and are not palpable easily. There are even lipomas in internal organs, because wherever there is adipose tissue lipomas can form. For example, lipomas in the intestine or stomach, but they are rare injuries ”, explains the surgeon.

Do lipomas cause pain?

Depending on their location and size, lipomas can cause discomfort or even pain. As Doctor explains, “the pain or burning or burning sensation” resulting from “the growth of the lipoma and the fact that there are nerve fibers in the vicinity of the lipoma capsule” can be associated. ” In addition to these symptoms, their location sometimes poses aesthetic problems, which alone can justify their removal.

What are the causes and risk factors?

“Lipomas are usually sporadic situations and have no identifiable cause”, responds Doctor. According to the surgeon, there is no identified risk factor that ensures that the person is more or less likely to develop lipomas. “Not even obesity is a risk factor in itself. The obese person can have small lipomas and, being obese, they are more difficult to detect than in a thin individual ”, he explains.

Lipomas are uncommon in children and more common in adults, from the fourth decade onwards. There is no clear evidence that they are more frequent in one sex or the other.

There are some rare diseases that represent a genetic predisposition for the appearance of lipomas. “Among these rare inherited diseases are multiple familial lipomatosis, Gardner's syndrome, Cowden's syndrome or Madelung's disease. The multiple endocrine neoplasia syndrome type 1 is also frequently associated with large lipomas, in addition to the endocrine tumors that characterize it ”, describes the surgeon.

Are there malignant lipomas?

All lipomas are benign, but there is a type of cancer that can resemble lipoma. “The malignant relative of lipoma is sarcoma, a very aggressive cancer of connective tissue. When it originates in adipose connective tissue (fat) it is called liposarcoma. Both correspond to tumors originating in adipose tissue, but lipoma is a benign disease ”, distinguishes the surgeon.

Nodules of rapid growth, large or that change over time, therefore require extra medical attention. However, it is important to bear in mind that the incidence of liposarcomas is rare, since these tumors are usually located deep in the abdomen, in the retroperitoneum (behind the abdominal cavity) or in the limbs. Subcutaneous liposarcomas are not common.

How is the diagnosis made? 

In most cases, the clinical examination is sufficient to diagnose a lipoma.

"Any lump less than 5 centimeters that is suspected to be a lipoma, is practically always a benign disease and does not require any diagnostic clarification", assures the doctor. But if the nodule is deep, large (10 cm or more), fast-growing and / or painful, additional tests should be ordered:

• Ultrasound

This examination allows “to confirm that the nodule's characteristics are homogeneous, capsulated fat, which defines the presence of a lipoma.”

• Computed tomography(CT) or magnetic resonance imaging (MRI)

“In very extensive lesions - a lipoma over 10 or 15 centimeters - or deep - a lipoma that is located under the muscle or even inside the muscle - sometimes it is necessary to have a test whose accuracy is greater. In these cases, we opted for a CT or an MRI, to try to make the differential diagnosis between lipoma and liposarcoma. ”

• Biopsy

“When a nodule grows rapidly, the question of diagnostic confirmation arises. If it grows 1 to 3 centimeters in a few months, it requires a biopsy to characterize the lesion, excising the lipoma. ”

What are the forms of treatment?

There is no medical treatment for lipomas. If there is an aesthetic or functional impact on the person, if it causes discomfort and / or has rapid growth, removal may be indicated. “Only small, stable lesions are not indicated for surgery, unless they cause symptoms or the patient considers them unsightly”, contextualizes the surgeon. Removal, he explains, can be done in one of two ways:

• Conventional surgical excision

It is the preferred technique, as it allows you to remove the lipoma exclusively. “In accessible and small-sized lesions, a small incision is made under local anesthesia, through which the lipoma is extracted, and then it is closed in the most appropriate way possible to leave an aesthetic scar. Large or deep lipomas are usually removed under general anesthesia. The injury is completely isolated and excised. ”

• Liposuction

This technique can also be used, but it involves an increased risk of lipoma recurrence. Liposuction is a blind fat removal technique, in which not only the fat from the lipoma is extracted, but also the normal fat and it is always difficult to guarantee complete removal of the nodule.