adipose tissue tumor, fat, tumor, skin, adipose tissue tumor
Does a lipoma have to be removed?
Lipomas are harmless benign growths of adipose tissue cells that usually do not cause the patient any discomfort (see: Lipoma symptoms). Therefore, there is rarely a medical need for the treatment of a lipoma. In most cases, therapy is carried out at the request of the patient, who sees the lipoma as a cosmetic impairment. In addition to lipomas, there are also so-called piezo-drawn nodules
Surgical removal
The therapy of first choice is the surgical removal of a lipoma. Reasons for an operation of the lipoma:
- Lipomas, which are visually disturbing due to their conspicuous position
- Lipomas that have a diameter of more than 5cm,
- Adipose tumors that cause symptoms due to their location (for example, by pressing on a nerve, which can cause sensory disturbances, pressing on a tendon, which can cause pain, or in the case of a giant lipoma, even compressing internal organs and affecting their function)
- Lipoma, which cannot be reliably distinguished from a liposarcoma, i.e. a malignant tumor of the fatty tissue cells, from the outside and whose removal of the tissue serves for histological clarification.
Most lipomas are located subcutaneously, in the subcutaneous fatty tissue. Since they are so close to the skin surface and can usually be easily separated from the surrounding tissue by a capsule, their removal is relatively easy in most cases.
For this “standard type” of lipoma, a local anesthetic is sufficient. For this purpose, the anesthetic is injected into the skin directly above or just next to the lipoma and waited for a few minutes before the affected area is completely free of pain and the operation can begin. The surgeon makes an incision directly above the lipoma, the length of which should correspond approximately to the structure to be removed.
Normally, only a thin layer of fatty tissue needs to be removed before the lipoma is encountered. The lipoma and its capsule can then be more or less pressed out of the skin. The next step is to cut off the blood vessels that supply the lipoma.
If the blood supply is thus cut off, it can then be cut out. If a lipoma is quite large, it may be useful to insert a drainage (for suction) into the resulting cavity. Unfortunately, there are also lipomas that cannot be removed so easily.
These include, for example, those fat tumors that are located inside a body cavity. It is not uncommon for lipomas to occur in the thoracic or abdominal cavity, where they are more difficult to reach from the outside and can also reach extraordinary sizes (it has often happened that lipomas weighing several kilos have been removed from the abdominal cavity), which presents the surgeon with a greater challenge. In such cases local anesthesia is usually not sufficient and the patient should be put under general anesthesia. However, even smaller lipomas can sometimes be a difficult procedure if they are in direct contact with a nerve or even lie in the nerve, which must be spared during surgery to avoid complications and permanent damage. It is also rare that a tumor that was initially diagnosed as a lipoma turns out to be another tumor during surgery (for example, a hemangioma or a malignant liposarcoma), which then requires another surgical procedure for removal.
