A Study on Epidemiology of Subcutaneous Lipomas
HPE 1004 - Introduction to Epidemiology
University of Cincinnati
December 10, 2023
Lipoma is a slow growing, encapsulated, lobulated, fluctuant and
painless tumour composed of fat cells. They occur anywhere in the
body where fat is found and hence the name ‘universal tumour’ or
‘ubiquitous tumour’. Head and neck, abdominal wall and thighs are
the favoured sites. The masses are often benign, and while the age of
onset can vary, they most often develop between the age of 40 and 60.
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas. 71. 90% (75 out of 126) were smaller than 5 cm. Multiple
subcutaneous lipomas were found in 22 patients (17. 46%), most of
them young males. 62. 98 % (70 out of 126) patients were between the
age group of 40 to 60 years. Males were more commonly affected as
78 (61. 90%) patients were males and 48 (38. 09%) patients were
females.
Introduction
Lipomas present as the most common tumour in the body. More
common in obese individuals1, these benign soft tissue neoplasms
typically develop in the 5th to 7th decade of life. Lipomas are rarely
found in children. Histologically, lipomas are nearly indistinguishable
from normal adipose tissue. Although the histological appearance
resembles mature adipose tissue, lipomas are not derived from mature
adipocytes but rather from mesenchymal preadipocytes. Lipomas are
estimated to be multiple in 5-15% of patients. Multiple causative
factors have been proposed that include genetic, traumatic, and
metabolic triggers. Lipoma formation following physical trauma has
been reported widely. Growth factors, cytokines, and other
inflammatory mediators released following blunt trauma to soft tissue
induce pre-adipocyte differentiation into mature adipocytes and
formed a clinically apparent mass. Fat necrosis and the extravasation
of blood secondary to trauma stimulated preadipocyte differentiation
has also been postulated.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
Materials and Methods
This was a retrospective study where patient data was collected from
the Surgical Outpatient department records at the department of
Surgery in a peripheral hospital in Nasik, of all patients who reported
with a subcutaneous, painless, slow growing tumour who were
clinically diagnosed as lipoma. Further histopathology reports of these
patients who underwent excision of the tumour were studied and data
analysed.
Inclusion and exclusion criteria
All asymptomatic, subcutaneous swellings were included in the study.
FNAC was done for all patients prior to excision of the tumour and
FNAC proven lipoma patients were included in the study. Spinal cord
lipomas diagnosed on MRI scan imaging and lipoma of the breast
diagnosed on Ultrasonography studies and FNAC were excluded. No
FNAC report was suggestive of malignancy.
Sample collection
Sample was personally sent by the operating / treating Surgeon in the
Operating room under sterile conditions after excision of the tumour
and was transported to the lab within one hour of collection.
Statistical analysis
All 126 patients who had a non-visceral lipoma diagnosed on
histopathological examination during a period of 1 year were analysed
retrospectively as regards the age, gender, size, site and multiplicity of
the lipomas.
Results
98% (70 out of 126) patients were between the age group of 40 to 60
years. Males were more commonly affected as 78 (90%) patients were
males and 48 (09%) patients were females. 78 out of 126 lipomas
were found on head and neck and trunk making it. 52%. (15%) out of
126 lipomas affected the forearm. . 90% (75 out of 126) were smaller
than 5 cm. Multiple subcutaneous lipomas were found in 22 patients (.
46%), most of them young males.
Discussion
Lipomas occur anywhere in the body where fat is found and hence the
name ‘universal tumour’ or ‘ubiquitous tumour’. Lipomas are defined
as mesenchymal tumors which typically lie subcutaneously. Less
commonly, they can also be found on internal organs, such as stomach
and bowels. These masses are not typically attached to underlying
muscle fascia. Lipomas are composed of lobulated, slow-growing,
mature adipose tissue, having a minimal connective tissue stroma.
They are commonly enclosed in a thin, fibrous capsule.
Pathophysiology
Multiple causative factors have been proposed that include genetic,
traumatic, and metabolic triggers. Lipoma formation following
physical trauma has been reported widely. Lipomas have been
associated with numerous pathophysiological processes. Diabetes,
hyperlipidemia, mitochondrial dysfunction, and endocrinopathies such
as nodular goiter, multiple endocrine neoplasia type, and Cushing's
syndrome have been noted.
Presentation
Patients often complain of a soft, mobile mass of tissue they can feel
under the skin. These are typically painless unless they encroach
joints, nerves, or blood vessels. Rarely, these lipomas can form in
muscles or organs. Lipomas are mostly harmless and are only excised
if they cause pain due to their location, if they are impacting an
organ’s function or for cosmetic reasons.
Histology
Histologic examination of lipomas reveals mature, normal-appearing
adipocytes with a small eccentric nucleus. Histologic subtypes of
lipomas include angiolipomas, myelolipomas, angiomyolipomas,
myelolipomas, fibrolipomas, ossifying lipoma, hibernomas, spindle
cell lipomas, pleomorphic lipomas, chondroid lipomas, and neural
fibrolipomas. Common lipomas and its variants must be distinguished
from liposarcomas which are a malignant lipomatous neoplasm
containing lipoblasts, which are characterized by coarse vacuoles and
one or more scalloped, hyperchromatic nuclei.
Diagnosis
When subcutaneous, diagnosis can be made by a characteristic
“doughy” feel on palpation. Application of an ice pack to the tumor to
chill and harden the fat has also been used to aid in diagnosis. On
plain radiograph, lipomas appear as an area of characteristic
radiolucency referred to as a “water-clear density. Ultrasound
examination demonstrates a homogeneous and circumscribed
hyperechoic area. Both CT and MR imaging are reliable for
localization, diagnosis, size estimation, as well as evaluation of bony
involvement.
Treatment
The treatment modalities include intra-lesional steroids16,
intralesional transcutaneous sodium deoxycholate17 injections,
liposuction18 of the tumor, or surgical excision. Surgical excision is
likely the most effective method to prevent recurrences, though the
encapsulation must also be removed for the most effective treatment
and to decrease the risk of reoccurrence. If the decision is made to
excise lipomas, then it should be done while the lesions are smaller
rather than after they grow larger to reduce the risk of these
encroaching on joints, nerves, and blood vessels, thus making the
excision more difficult and invasive. However, surgical resection or
observation without intervention remain the standard of care.
Complications
Lipomas rarely cause complications. However, patients with untreated
compression syndromes may experience decreased neurological
function and intractable neuropathic pain. Rarely, recurrence may
occur and is typically associated with incomplete excision of deep,
infiltrative lesions or lesions entangled within neurovascular
structures.
Malignant variation
Liposarcomas present as one of the most common soft tissue sarcomas
of the body. Like lipomas, these tumors usually present as a small,
slowly enlarging painless mass, although high-grade lesions may
develop rapidly. Liposarcomas most commonly present as deep-seated
tumors in the retroperitoneum or, classically, on the thighs. The
etiology of a liposarcoma is unknown, but most are thought to arise de
novo. Reports of malignant transformation of lipomas are rare in the
literature. Treatment of liposarcomas requires wide local excision and
in some cases may necessitate amputation. Occasionally,
(neo)adjuvant chemotherapy or radiotherapy are administered,
especially for high-grade lesions. The most common complications of
liposarcomas are recurrence and metastasis.
Conclusion
Lipomas are common, benign, slow growing, generally asymptomatic
tumour. Simple subcutaneous lipomas may be diagnosed by history
and physical examination alone. FNAC may be done to differentiate
them from epidermoid cyst or ganglion which are the closest
differential diagnoses. Most lipomas are treated with surgical excision
with few complications or recurrence. Malignant degeneration is rare.
The prognosis for benign lipomas is very good. Once these tumors are
excised, mainly for cosmetic reasons, they often do not return.
However, is imperative that the fibrous capsule surrounding the
lipoma is entirely removed to prevent recurrence.
