What is a Lipoma?
A lipoma is a mass or lump that is composed of adipocytes or fat cells. Lipoma is a very common, noncancerous tumor that grows slowly. Oftentimes, they build up beneath our skin, specifically in the subcutaneous layer. This is the layer that is found between the skin and the muscle layer.
Lipomas can advance in size and numerous growths can occur. Usually, they are located in the arms, shoulders, back and neck. There would be instance although rarely wherein the lipomas build up in other organs in the body as well. The growth rate of lipomas are radically slow, building up round, flat lumps that are spongy or soft which can be moved easily under the skin in all directions. Lipomas can sometimes be ugly however the person having this will most likely not be able to feel any discomfort, tenderness or pain.
A lipoma usually starts to develop after a trauma or a tissue injury. It is heredo-familial which means if you have a family member who has this condition, your predisposition of getting one is big. Generally, lipomas occur in middle-aged or older people. Mostly, treatment is not required for lipomas. However, should the size or location of a lipoma result in weakness, pain or other types of problems and discomfort, the person must seek medical attention at once.
Lipoma is diagnosed because of its formation of a lump or a collection of lumps that grow beneath the skin. They generally increase in size in a slow manner. Its presence is sometimes undetectable. Oftentimes, the patient would not even notice a lipoma even if it had been there already for a number of years. Lipomas commonly grow on the back, abdomen, arms, legs and neck. However, there are instances when they would also grow inside the internal organs. Majority of lipomas are small in size, its diameter is similar to those of a large marble. In rare conditions, lipomas are a radically bigger. Lipomas are flattened, round lumps that are rubbery and soft to touch. They can be moved easily even when little pressure is applied on it. They are not tender. Most commonly, pain would not be felt in areas where there is a lipoma unless it is bruised or squeezed very intensely A lipoma may also cause pain and other medical problem. However, this depends largely on its size and location. It is also vary whether the surrounding tissues or adjacent organs are affected. If a certain nerve is affected by a lipoma, pain will ultimately be felt by the patient.
In order to correctly diagnose the presence of a lipoma, your health care provider or physician may perform a thorough physical examination. Additionally, an ultrasound or other imaging test, such as Computed Tomography or CT scan and Magnetic Resonance Imaging or MRI will be performed in order to determine if the lipoma is large, appears to be deeper than the fatty tissue or has atypical features..Also, a biopsy or tissue sample removal may be needed for histopathology. This test is done to determine the presence of malignancy in the lipoma.
Rarely, there would be instances that a lump resembling a lipoma may actually be a form of cancer called liposarcoma. Liposarcomas are cancerous tumors that are found in fatty cells or tissues. Their growth rate is fast. Usually, if you put pressure on it, it will not move under the skin and are oftentimes painful and tender to touch.
Oftentimes, lipomas do not warrant medical attention. They are only removed in instances where pain is felt or if the lipoma rapidly increases in size. The removal of lipomas would also be necessary if it poses serious cosmetic disturbances that could affect the patient’s ability to function fully and lead a normal life.
If a benign or noncancerous lipoma is found beneath your skin, your health care provider or physician will advise you of the best treatment option for that condition.
For benign lipoma, the modalities of treatment required are as follows:
Removal through surgery
Lipomas are usually removed surgically by way of cutting them out. After the removal, its recurrence rate is very low.
A needle and a large syringe is required with this treatment in order to remove the fatty lump. However, removing the lipoma completely is very hard with this type of approach.
This modality of treatment is utilized to decrease the size of the lipoma, however, it does not entirely remove the tumor from the body.
It is still required to undergo further diagnostic evaluations in order to verify the root cause of the lump or to identify whether it is cancerous or not.
The type of surgery to be performed depends on the location of the lipoma. The adjacent nerves are usually preserved during the procedure. This is the utmost priority during the surgery. However, in cases where the lipomas are found to be malignant or cancerous, it is very important to have a wide surgical margin. Commonly, the procedure is performed under general anesthesia. Even though majority of lipomas can be taken out without touching the adjacent muscles, there would still be instances wherein, the muscles may require cutting and subsequently be re-attached in order to remove a deep lipoma, for example in the buttock. The procedure usually last about 2-4 hours. If during the procedure, the muscle was not cut minimal post operative pain would be felt by the patient.
The procedure can either be performed in day surgery or in the main operating theatre. This would depend largely on the location of the lipoma. The patient is required to be on nothing per orem status. Hence, he or she is not allowed to eat nor drink after midnight the day prior to the contemplated procedure. The patient will be allowed to take his or her usual medications but only with a little sip of water the morning before the procedure. The patient will then be brought to the operating theatre where the procedure will be performed. Afterwards, he or she will then be transferred to the post anesthesia care unit or recovery room wherein he or she will be closely monitored. At this time, the patient’s family will now be allowed to enter. Depending on the patient’s condition, he or she can either be brought to the neurosurgery ward or be discharged an hour or two after the procedure.
The part or limb where the operation was performed on should be used minimally for the first two weeks after the procedure so as to prevent bleeding. The patient is encouraged to perform gentle range-of-motion exercises. The patient can still take a bath after the procedure since an occlusive dressing is placed on the operative site. Usually, the dressing can be removed three days after the procedure. Depending on the patient’s condition and on his or her job description, the patient can return to work. However, only work with minimal exertion of effort is advised. After three to seven working days, the patient can obtain the pathology result from the hospital and bring it to his or her doctor for further evaluation.
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