Lipomas - symptoms, consequences, removal methods

Bohyan

Tigran Surenovich

Experience 36 years

Surgeon of the highest category, Doctor of Medical Sciences, member of the International Association of Surgeons, Gastroenterologists and Oncologists

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Lipoma (fat) is a benign formation in the form of small nodules, the appearance of which is associated with the accumulation and compaction of excess adipose tissue. The size of the lipoma may increase or remain stable. When exposed to unfavorable factors, pockets of pathogenic microflora can form inside the wen, which makes it a source of other serious diseases of internal organs. The unaesthetic appearance of formations protruding on the surface of the skin is also important. Therefore, in most cases, a decision is made to remove the tumor and its subsequent histological examination to clarify the nature of the wen - benign or malignant.

The area of ​​localization of lipoma is the back, chest, face, limbs, mammary glands, structure of internal organs. The formation can be detected accidentally during diagnostic procedures or during palpation. The edges of the lipoma are dense and clear, the formation is mobile, and its palpation is painless. It is more difficult to detect a lipoma in the tissues of internal organs. However, it is precisely such cases that are recognized as the most dangerous, threatening disruptions in the functioning of the affected tissue area.

Classification

Depending on the internal structure there are:

• Myolipomas are formations from muscle cells.
• Angiolipomas are lipomas with the inclusion of blood vessels.
• Myxolipomas are tumors containing mucus.
• Fibrolipomas are formations containing connective tissue.

It is possible to accurately determine the nature of the formation only after a thorough diagnosis. It should not be postponed for the foreseeable future, especially if the lipoma quickly increases in size and causes discomfort.

What to do if lipomas hurt?

In its normal state, a lipoma has a spherical appearance (a round tumor with clear boundaries up to 5-7 cm in diameter). The lipoma is enclosed in a capsule. In most cases, it has a nodular structure, does not hurt, does not itch, does not bother palpation and practically does not grow. If the lipoma has become painful and is growing rapidly, then this may indicate not only inflammation, but also possible malignancy of the tumor. The catalyst for the inflammatory process in a lipoma can be injury and infection that has entered the body. Sometimes the cause of pain in a lipoma can be compression of nerves and blood vessels by the tumor. Pain in a lipoma is a signal for the patient to urgently seek advice and help from a doctor.

Rice. 2. If the lipoma hurts, it needs to be removed

Causes of lipoma

The general pattern of the appearance of wen is the accumulation of fat cells due to a violation of fat metabolism in the body. If measures to treat the problem are not taken in a timely manner, the formation quickly grows, pinching nearby muscles and blood vessels. Among the causes of lipoma that influence the unfavorable course of the pathology, it is worth noting:

• Hormonal disorders, a period of hormonal changes in the body.
• Metabolic failures.
• Disturbances in the diet with a predominance of food of animal origin.
• Diseases of the kidneys and liver, pancreas and thyroid gland.
• Bad habits.
• Diabetes.
• Genetic predisposition.

Also, the formation of excess adipose tissue is affected by physical inactivity, a sedentary lifestyle and refusal of full-fledged physical activity.

Reasons for appearance

There are many factors that influence the formation of lipomas. Among the reasons are hereditary predisposition, impaired metabolism of fatty acids in the body, liver disease, pancreatic disease, non-compliance or violation of hygiene rules.

For a long time it was believed that soft tissue injury predisposes to the development of lipomas, but this fact was subsequently refuted in research. Thus, doctors agree that one reason that would explain all the processes has not yet been found. However, predisposition to gastrointestinal lipomas has a proven connection with a gene mutation on chromosome 12. In other cases, the reasons remain unknown.

Symptoms

The main localization of wen is the place of deposition of adipose tissue. At first it is a soft compaction, which gradually increases in size. The only symptom of a lipoma is the formation of a noticeable tubercle with a movable structure, which can be felt when pressed. There is no pain when palpating the lipoma on the back or arms.

If the wen is localized in the structure or on the surface of internal organs, disturbances in their functioning may indicate pathology. The disease is also accompanied by characteristic symptoms:

• a lipoma in the esophagus causes coughing, nausea and vomiting;
• formations on the bronchi and trachea cause a constant dry cough of a paroxysmal nature;
• lipoma on tendons and cartilage limits their mobility and causes pain;
• a lump in the mammary gland gives pain;
• fatty deposits in the kidneys provoke colic, lower back pain, and increased blood pressure;
• a lipoma in the head causes dizziness and headaches;
• a formation in the neck makes it difficult to swallow food and also causes hoarseness;
• A lipoma in the heart area causes arrhythmia and heart failure.

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Symptoms of the disease

Unlike most other tumors, lipoma grows and develops quite slowly, causing virtually no inconvenience to the carrier. Patients seek its removal mainly for two reasons:

• The lipoma appears on an open area of ​​skin and does not look aesthetically pleasing.
• The tumor has formed in the immediate vicinity of the nerve endings and, as it grows, begins to put pressure on them.

It is also not uncommon for the skin over the lipoma to become damaged and the wound to become infected. When inflammatory processes are added to the tumor, the patient may note:

• Decreased mobility and functionality of the affected area.
• Minor pain.
• Increased body temperature.
• Redness of the skin.
• Inflammation in the area where the skin has been damaged.
• Local (depending on the location of the tumor) manifestations: wheezing and difficulty swallowing - in the neck, arrhythmia - if the heart is affected, dizziness and migraine if the lipoma is located near the vessels of the head.

In this case, pathology can already cause problems, and considerable ones. You should consult a doctor as soon as you discover that:

• The tumor became denser and its growth rate noticeably accelerated.
• The lipoma appeared on the face or on any other open, and therefore least protected, area of ​​the skin.
• The tumor has formed in a high-friction zone, where it can easily be damaged.
• The lump turned red, began to cause discomfort, began to bleed and/or discharge pus.

Methods for diagnosing lipomas

The long period of latent progression greatly complicates the diagnosis of soft tissue lipoma in the early stages of development. More often, pathology is detected when the wen reaches a size of 1.5-2 cm and is easily palpable under the skin. To carry out differentiated diagnostics and confirm the benign nature of the formation, you can:

• Blood tests to exclude viral or bacterial infections, as well as the absence of an inflammatory process.
• X-ray of the chest, limbs or abdomen. Allows you to detect a formation, clarify its location, calculate its size and assess the condition of surrounding tissues.
• Ultrasonography. It is used as an additional diagnostic method when the presence of a lipoma is confirmed by other examination methods.
• Computed and magnetic resonance imaging. Effective methods to determine the location and size of the lipoma, as well as confirm its benign nature.
• A biopsy of wen tissue to analyze it for the risk of cells degenerating into a malignant structure.

If the patient has other diseases of the internal organs, the diagnosis of lipoma is carried out taking into account their characteristics, and deciphering the results suggests the mutual influence of pathologies, making it possible to more accurately determine the cause of the appearance of the wen.

Treatment methods

The treatment method is selected based on the location of the tumor, size and medical history of the patient. First of all, the doctor must make sure that the patient’s neoplasm is benign. To do this, the doctor carefully examines the patient, collects anamnesis and, if necessary, refers him to the necessary tests. For the differential diagnosis of lipomas, ultrasound examination of soft tissues, computed tomography, magnetic resonance imaging are used and, if a malignant tumor is suspected, a tumor biopsy is taken.

The most common type of tumor from adipose tissue is a subcutaneous lipoma, which does not cause dysfunction of organs, systems and does not threaten the patient’s life, and removal is performed only for cosmetic purposes.

Also, indications for surgical treatment of lipoma are large tumor sizes, 5 cm or more, and the presence of symptoms caused by the tumor.

There is no effective conservative treatment for lipomas. It is also worth noting that traditional methods such as heating and applying ice do not affect tumors from adipose tissue. However, they can cause serious complications if the neoplasm is of a different nature. For example, when atheroma is heated (atheroma is an accumulation of sebaceous secretion that clogs the duct of the sebaceous gland and causes inflammation), inflammation may spread and infect healthy tissues that are nearby.

Among the surgical methods for treating lipomas are:

• lipoma excision
• liposuction
• laser removal
• endoscopic method (for gastrointestinal lipomas)

Treatment

If small lipomas are detected in a patient, a wait-and-see approach is chosen, which involves ultrasound monitoring several times a year. However, there are often cases when the doctor decides in favor of surgical intervention. Surgery is necessary if:

• The tumor grows rapidly, engulfing neighboring tissues and blood vessels.
• The lipoma rises above the surface of the skin, giving an unaesthetic cosmetic effect.
• The development of a wen gives persistent pain.
• Due to the growth of adipose tissue, the functioning of internal organs and the circulatory system is disrupted.

Removing or destroying a lipoma on the neck or back is possible in the following ways:

• Endoscopic method. It involves removing the tumor along with the capsule through a small incision in the skin.
• Liposuction is the extraction of adipose tissue by softening it and stretching it through a thin needle. Does not leave scars and does not injure the skin.
• Excision of a lipoma is the removal of a wen during a classic surgical intervention.

The optimal method is selected taking into account the general condition of the patient and the size of the lipoma.

BENIGN TUMORS OF ADIPOSE TISSUE

Lipoma

One of the most common benign tumors (30-40%). It can occur anywhere there is fatty tissue. When localized in the dermis, it is usually encapsulated, in other parts of the body it is poorly demarcated. Tumors localized in the retroperitoneal space can become malignant; other localizations practically do not become malignant. Lipomas are often multiple and sometimes develop symmetrically. Their growth is not related to the general condition of the body. The tumor has the shape of a lobular node. With long-term existence in the lipoma, dystrophic changes, calcification, and ossification can develop.

There are numerous variants of mature fatty tumors, which differ from the classic lipoma both in clinical manifestations and in some morphological features.

Myelolipoma

A rare tumor, most often found in the retroperitoneum, pelvic tissue, and adrenal glands. Does not become malignant.

Subcutaneous angiolipoma

Numerous painful nodes. It occurs more often in young men on the front wall of the abdomen, on the forearm.

Spindle cell lipoma

It is observed more often in adult men (90%). The node is round in shape, dense, slowly growing, most often localized in the area of ​​the shoulder joint and back. Recurrence and metastasis after excision have not been described, despite the fact that the tumor can infiltrate surrounding tissues.

In chondro- and osteolipomas, metaplastic areas of bone and cartilage tissue are detected.

Benign lipoblastomatosis

It is divided into nodular (kind lipoblastoma) and diffuse (kind lipoblastomatosis) forms. Boys under 7 years of age (88%) get sick more often. The tumor is localized on the lower limb, in the buttocks and on the upper limb - the shoulder girdle and hand. Lesions of the neck, mediastinum, and trunk have also been described. The tumor node is encapsulated, lobulated, spherical in shape, and can reach 14 cm. After surgical treatment, relapses are possible, sometimes repeated. Metastases have not been described.

Gebernoma (fetal lipoma)

Lipoma from lipoblasts, pseudolipoma is an extremely rare tumor, localized in places where there is brown fat (neck, axillary region, sinus, mediastinum). Presented as a lobular node, usually small in size. Does not recur and does not metastasize.

Diagnosis and treatment of lipoma at the JSC Meditsina clinic in Moscow

The clinic of JSC "Medicine" in the Central Administrative District of Moscow is ready to offer professional assistance to patients with suspected single or multiple cases of lipoma development. The center’s specialists have high-quality equipment and extensive practical experience in using various methods of removing a tumor focus. Each patient is guaranteed attentive attention, referral to a full course of examinations and an individual approach to developing lipoma treatment tactics. Appointments are available on the clinic’s website and by calling the numbers provided.