LIPOMA BY MOMEN ALI KHAN

Lump A lump is a vague mass of body tissues

SwellingAny protuberance or enlargement of body part

Tumor (neoplasia)

A tumor is an abnormal mass of tissues the growth of which exceed and uncoordinated with that of normal tissues and persist in the same excessive manner after cessation f stimuli which evoked the changes , which is virtually autonomous, preys on host.

Lipoma

DefinitionBenign tumor of mature fat cell

Type According to presence of capsule According to anatomical location According to histology- Lipoma Fibrolipoma Neurolipoma Naeveolipoma

According to presence of capsuleEncapsulated lipomaDiffuse lipoma

According to anatomical locationSubcutaneousSubfascialSubserosalIntramuscularSubsynovialIntraarticular

Some notesPleural form – Lipomatosis

Called also universal tumor – because it can occur in all part of body.

It occur in all part except – Tip of nose Cartilaginous part of ear Brain Shaft of penis Eyelid

Common site encapsulated lipoma Neck Back Shoulder Upper limb

Lipoma may undergo malignant change Retoperitoneal Thigh Shoulder

In these site lipoma may undergo malignant change

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Clinical featurePainless swelling

Discomfort

Causes of painful lipomaDercum diseaseNeurolipoma

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Examination finding

A globular swelling in … … …(e.g. back) which is about … … cm in size, temperature not raised, nontender, surface lobulated, soft in consistency, margin well defined, slip sign positive, overlying skin free, swelling not attached with dipper structure, freely mobile. It is not-fluctuant, transillumination test negative. Regional lymph not enlarged.

So my diagnosis- subcutaneous lipoma in back.

Differential diagnosis

Neurofibroma Sebaceous cyst Hemangioma Fibroma

Lipoma is fixed when fat necrosis occur

Complication of lipomaoHuge size and mechanical discomfortoHemorrhageoInfection oMyxomatous degenerationoMalignant conversion

Dercum disease

Tender deposition of fat especially on trunk

Diagnosis

HistoryExamination findingInvestigation – FNAC X- Ray of regional area

ManagementSurgeryExcision under local anesthesiaIn some case require general anesthesia – diffuse lipoma , very large size.

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