Lipoma: what is it, causes, treatment, removal, surgery
Lipoma is one of the benign neoplasms originating from adipose tissue. Lipoma are usually located in the subcutaneous fat of the back, neck, extremities, but perhaps her education in the internal organs, the meninges, the cavities of the heart, retroperitoneal space. Such localization can be quite dangerous because of the risk of compression of the neighboring organs and tissues. Lipomas located within the body, are more prone to malignancy.
Lipoma is widespread and quite common, equally common among men and women. The formation appears most often after 30 years, and especially among the elderly, in whom the tumor can wear multiple character.
Externally a lipoma is a painless nodular lesion, well move on palpation, not connected with surrounding tissues and germinating them. A lipoma is usually soft but with increasing content of connective tissue it becomes more dense (fibrolipoma). As a rule, the tumor is supplied abundantly, and a large number of newly formed vessels allows to allocate its variety – angiolipoma. Sizes rarely exceed 3-5 cm but asymptomatic growth may lead to the formation of the node to 10 cm and more. As a rule, cosmetic defect painless the lip forces the patient to go to a specialist for help.
The tumor grows in the form of a node, has a lobed structure and a well-defined capsule, which is especially evident in subcutaneous location. Sometimes lipoma pushes the surrounding tissue or sprouts between the vessels or nerves, then there are symptoms of impaired blood flow or pain. The so-called infiltrating lipoma grows in thicker muscles, forms a clear boundary and is very similar in this malignant neoplasia, ingrowing into the surrounding tissue. Slow growth and absolute purity tumors allow, in many cases, limited supervision, and small lipomas can be removed minimally invasive, no incisions or sutures.
Lipomas often identified with the white bumps which are not actually tumors. Wen (sebaceous cyst) is formed by violation of the outflow of the contents of the sebaceous glands, which are stretched and filled with fat secret. With increasing atheroma in size, it is a dense fibrous capsule, and externally, this process may resemble a tumor. In the lumen of the cystic expanded glands no breeding of fat cells, and increasing education solely due to accumulation of sebum. In some sources the term «Wen» is used against tumors.
Lipoma usually single, multiple, growth is more characteristic for women, especially in the presence of comorbidity (diabetes and other endocrine disorders). Most tumors are located subcutaneously, but other options are possible growth. For example, the so-called annular lipoma located in the neck, covers her ring and with the growth can cause respiratory failure, dyspnea, difficulty swallowing.
Leaking asymptomatic, a lipoma can cause significant cosmetic defect, especially when located on the face, head, neck, and so are localization themselves can request the assistance of the surgeon, even if the tumor is relatively small and poses no threat to patient’s life.
In the body of adults is sometimes possible to detect brown fat, is deposited in the form of Islands on the back, neck, in the adrenal glands. This brown fat is a germ, but in some cases may persist in the adult state as a particular kind of fat. A tumor that is composed of brown fat, called hibernoma. Significant differences within hibernoma no, it is more often diagnosed in children and does not recur.
Special varieties of lipomas are myelolipoma, when in addition to the adipose tissue found pockets of blood, does not break with the function of bone marrow. Most myelolipoma grows inside of the body (retroperitoneal, pelvic cavity).
Annular lipoma of the neck, some authors do not refer to the actual tumors, but it usually is diagnosed in individuals suffering from alcoholism with a serious impaired hepatic function.
Subcutanat angiolipoma found among young people, often men, and represents numerous subcutaneous painful nodes in the anterior abdominal wall or forearm. Controlpane and osteolizom different member Islands of cartilage and bone.
At long existence of the tumor can be observed dystrophic changes – osoznanie, the deposition of calcium salts, which is not reflected in its current or forecast.
The causes of lipomas
Consensus regarding the causes of lipoma is not, however, assume the role of some factors:
- Changes in fat metabolism;
- Comorbidities – diabetes mellitus, disorders of the thyroid and of the pancreas, liver disease, alcoholism, etc.;
- Older age and decrease in natural immunity.
Hereditary predisposition to tumors of fatty tissue are seen when lipomatosis, when multiple nodes are formed all over the body to family members. Most likely, the cause of this phenomenon is a genetic defect that is passed from parents to offspring regardless of their sex.
Disorders of lipid metabolism with a certain probability also can promote the growth of lipomas. However, this does not mean that the tumor must occur in obese people with excess fat. In lean persons, the lipoma can also be found quite often and can reach a considerable size.
In the human body there are mechanisms regulating the deposition of subcutaneous fat in different amounts in different parts of the world. For stress, adverse external factors, possible failures in the work of such regulation, then locally there is an increase in the formation of adipose tissue and tumor growth.
Injuries in the regeneration stage may be accompanied by increased cell proliferation, which may be the cause of lipomas in the damage of subcutaneous fat.
Signs and symptoms of tumors of adipose tissue
In the initial stages the tumor is not danger for the patient and does not cause any concern, changes in the skin are not typical and the patient often does not consider it necessary to consult a doctor. The localization of the lipoma on the back or neck, you should be careful during the massage, as this effect causes increased blood flow and can contribute to the growth of tumors.
Single lipomas have the form of nodules, soft or dense consistency, painless, easily movable on palpation. They most often appear on the back, neck, breast, thighs or forearms. If lipoma is subcutaneous, it is easy to detect even during the examination the tumor appears as a well rounded education, the skin over which is not changed. When the location of the lipoma in the course of nerve fibers, the compression of the last large tumor nodes, there is pain. In addition, certain hereditary forms of lipomatosis accompanied by the appearance of multiple painful nodules in different parts of the body.
Lipoma located inside the body, seen or felt impossible, but the signs of compression of the internal organs, blood vessels or nerve usually indicate the presence of a tumor, which can easily be detected by modern research methods.
In the presence of marked cosmetic defect possible symptoms of disorders psycho-emotional state, because such tumors are visible to others and spoil the appearance of which particularly concerned women.
Even a small lipoma on the face can cause serious psychological discomfort, requiring removal of the tumors, which in other sites could be just monitored.
A characteristic sign of malignant nature of the nodes on the body is the lack of their reduction by reducing the weight of the patient. Moreover, the tumor can grow and due to the accumulation of cell mass, and due to the change in the ratio of tumor size with the body size of the patient.
Lipomas located in the hand (forearm, hand) or the thigh is more prone to cause pain syndrome as you increase its size because of the proximity of blood vessels, nerves and tendons. When compression of the vessels appears aching pain, aggravated by physical exertion on the limb. If the lipoma arose in one of the forearms, it is highly likely the appearance from the other side.
Tumors located in parenchymatous organs, the eye can not be seen, but characteristic symptom of their presence can be a nagging intermittent pain and dysfunction of the body in which they arise. The most characteristic lesions of the liver, kidneys, and sometimes ovaries, spleen, stomach wall or intestine.
Lipomas on the head are usually diagnosed in women, probably due to more frequent supercooling tissue while neglect of warm headwear. Such tumors reach large sizes, as visible to the naked eye already in the early stages of development, the patient definitely going to the doctor for improving the appearance of the defect. A favorite place of localization of the tumor be the cheeks, forehead, border of hair growth and the scalp, chin.
Lipoma of the brain is rare but if it appears, the symptoms are quite severe: hallucinations, headaches, disorders of motor function, vision, disturbance of CSF dynamics. Lipoma of the cerebral ventricles in newborn babies can lead to hydrocephalus and severe developmental delays. In addition to compression of certain parts of the brain, the tumor causes increased intracranial pressure that is manifested by a concern for children, intense headaches, vomiting.
Lipoma of the anterior surface of the neck can cause changes in the voice, impaired passage of food through the esophagus, painful hiccups. If it compresses the jugular vein, the impaired outflow of venous blood from the brain, and patients complain of headache, dizziness, a decrease in the activity of mental activity. When the location of the tumor on the back of the neck these symptoms are absent, but possible compression of spinal roots and pain.
Lipoma of the breast usually develops from the adipose tissue of this region. The external signs and the clinic does not have differences from other localizations of the tumor – node is painless, moves easily, the skin over it is not changed. With a significant amount of fatty tissue around the breast tumor can be detected immediately, but as soon as the woman probing at soft movable nodule, she should immediately consult with mammologist.
Especially dangerous is a lipoma in the cavities of the heart, provoking the development of arrhythmias and heart failure due to violations of the contractile function of the myocardium. Taking a significant amount of atrium or ventricle, the tumor disrupts blood flow and can lead to pulmonary edema, acute venous stagnation in the big circle of blood circulation and even cardiac arrest. To save the patient’s life in such cases is only capable of operation in cardiac surgery hospital.
Diagnosis of lipoma
Subcutaneous location of the lipoma diagnosis does not cause difficulties already at the inspection and palpation of education doctor. The diagnosis can be clarified with the help of ultrasound.
The presence of a lipoma located in the parenchymatous organ or the body cavity, the retroperitoneal space requires a more serious approach and use of additional methods of examinations, allowing to specify the localization, the tumor size and its correlation with surrounding tissues. Patients:
- CT, which can be combined with contrast of blood vessels;
If a thorough examination of the patient occurs not only clarification of the characteristics of lipoma, but also the exclusion of more dangerous pathological processes (aneurysm vessel, a parasitic infestation), including malignant tumors. Sometimes the diagnosis of lipoma is established by exclusion of other diseases and changes in tumor character.
Biochemical analysis of blood often does not have any features, but some patients possible changes in the content of cholesterol and lipid fractions.
The most accurate way to diagnose is considered to be a morphological study of the tumor, which usually occurs after removal of all lipomas. Puncture or intraoperative study ineffective due to the complexity of such studies for adipose tissue. Accurate diagnosis of the attending physician and the patient receive after an operation to remove the lipoma, if not applied minimally invasive techniques in which the tumor is destroyed immediately without leaving its fragments.
Treatment of lipomas involves the removal of all tumors with a capsule. As this process neoplastic, self-treatment is unacceptable in any form. First, the patient, not possessing special knowledge, can not accurately determine what is a tumor on the body. Second, no non-surgical methods to fight this tumor has not yet been invented, so when it detects suspicious of education, it is better to go to the doctor.
Of course, if the lipoma is small and does not cause any subjective or aesthetic concerns, watchful waiting is justified, because the risk from surgery may be higher than the expected benefit. The tumor grows very slowly and is not prone to malignancy, therefore, the monitoring by the doctor can be limited. Naturally, that doctor needs to offer this option, so a visit to him to postpone not worth it. At the request of the patient it can be stripped from a small, asymptomatic lipomas, if for any reason the patient wants necessarily to remove it.
Indications for removal of lipoma can be:
- Pain, compression of vessels and nerves in the tumor site;
- The signs of inflammation in the area of neoplasm growth;
- Rapid growth;
- Cosmetic defect;
- The dysfunction of the surrounding tissues or organs;
- The desire of the patient.
Intracranial, intracardiac lipomas and tumor that threatens his break with the localization in the abdominal cavity or retroperitoneal space, are absolute indications for surgery, postpone that should not because of possible dangerous complications.
The choice of anesthesia and the method of removal of lipomas is determined by its localization, size, patient’s condition. When small superficial formations is a preference for local anesthesia, but if the location of the tumor inside the body without General anesthesia is not necessary.
It is important to remove the lipoma radical, that is, not only the seat of the growth of adipose tissue, but also the surrounding capsule, otherwise relapse is almost inevitable, and the patient would have to go to the doctor and to endure unpleasant treatment. It is important to entrust a competent specialist treatment and to avoid any manipulation of the tumor in beauty salons and healers and folk healers in this case it is better to avoid.
To date, the most common ways to treat lipomas are considered:
Surgical treatment involves removal of the tumor with a scalpel. This approach is justified for large size tumors, located in tissues inaccessible to physical methods of influence on the cells. The doctor chooses the adequate method of pain relief in accordance with the location of the tumor and the patient’s condition. In most cases, lipoma removal can be performed on an outpatient basis, but for large tumors and, especially, growing inside the body, the patient will be offered hospitalization.
Surgery to remove lipomas usually consists of valesiana node, that is, the doctor excised adipose tissue along with the capsule, and then sutured in layers of tissue. The postoperative period generally favorable, and the sutures are removed in 7-10 days. It is clear that the lipoma located inside the cranial cavity or in the heart can only be removed by skilled cardiac and neurosurgeons, because such localization requires not only appropriate training of the patient for surgery, but can also be the cause of complications (bleeding, infection, etc.).
If the tumor has expressed lobed structure, «criss-crossing» the vessels, nerves or tendons, then its removal may be considerable difficulties, and the surgeon will require accurate and precise movements as the intersection of the nerve or vessel by negligence may lead to serious complications.
«Open» surgery to remove lipoma carries the risk of relapse in several times smaller than some of the more gentle of the technique because the surgeon has the opportunity to explore education and completely remove it within healthy tissue.
Among the gentle methods of treatment of lipomas has been proven the use of laser. Without this method of influence on pathologically changed tissue modern medicine it is hard to imagine, and Oncology is no exception. Through the targeted action of laser beam on the tumor tissue occurs its removal, while the surrounding cells remain untouched. After the laser removal no scars are left, healing occurs quickly, and relapses are extremely rare. Laser therapy is the method of choice for small superficial lipoma.
Radiowave treatment is less traumatic, does not leave marks on the body, and the tumor cells are killed through heating. Technique requires local anesthesia, complete healing takes a few days. Because the incision of the tissue is not made, then there is no need of suturing, and, hence, the scar will not. Radiono removes the entire tumor, together with the capsule, which allows minimizing the risk of recurrence. Radio-wave treatment almost does not cause complications, but is usually used when small dimensions of the tumor.
Puncture aspiration removal of lipomas involves the suctioning of its contents using a thick needle. The patient can go home within 15-20 minutes after the manipulation. The capsule of the tumor, particularly well expressed, it is not always able to remove, so the risk of relapse is quite high, and the efficiency depends on the ability and skill of the surgeon. The method does not require sutures and has a good cosmetic result.
Minimally invasive methods of treatment of the lipoma is indicated for small tumors, as well as their location on the face, neck, head and other exposed parts of the body.
Complications of removal of lipomas are rare and most often associated with infection of surgical wounds or bruising, although the formation of keloid scar recurrence of the tumor. Normally, the postoperative period is going well and when applying the gentle techniques the patient can immediately go home.
Treatment of folk remedies is not losing popularity with tumor pathology. On the Internet weight recipes how to get rid of lipomas by using lotions, compresses, etc. In the best case, such treatment does no harm, but quite likely not only the further growth of the tumor, but also damage to the skin in its location, which is fraught with inflammation, suppuration. In addition, even if we manage to get rid of the content of the lump, then remove the capsule alone does not work, so relapse is inevitable. It should be borne in mind that the tumor, benign seeming, it may be really something more dangerous, so self-medication with alternative medicine should not be.
The true causes of the growth of lipomas is unknown, so any prevention of these tumors did not exist. If you suspect a lipoma need to go to the doctor, but if there is a genetic predisposition to such tumors, it is necessary to closely monitor changes in the body and as necessary to visit a specialist.