Surgical management

1. LIPOMA

3. Introduction
 Commonest tumor of s/c tissue.
 Benign
 Arising from yellow fat
 Universal tumor
 Karyotype 12q change
 Hibernoma

4. Types
Encapsulated s/c lipoma
Diffuse variety
Multiple lipomas- Dercum’s d/s

6. Histological types
Fibrolipoma
Neurolipoma
Naevolipoma

7. Sites
location presentation d.d. Significance
s/c Mobile, lobular,
edge slips under
palp.fingers
Neurofibrom
a
Most common
variety
subfascial Diff. to appreciate
edge & lobulation
Implantation
dermoid ,
Tbtenosynovitis
In scalp- erodes
bone
Subsynovial,
intra-articular
Knee/elbow
sweling
Bursa,
Baker’s cyst
Intra-articular is
rare
Intermuscular Swelling Fibrosarcoma
Hematoma
More chance of
devpg
liposarcoma
Parosteal Feels hard Bony tumor Very, very rare

8. Contd..
location presentation d.d. Significance
Submucus Asymptomatic/
stridor
Intestinal/laryngea
l tumor
Intussusception
Subserosal Retroperitoneal
swelling
Hydronephrosis,
retroperitoneal
cyst
Liposarcoma
Extradural Very rare - -
Intraglandula
r
Breast, pancreas Cystic lesions Very rare

9. Clinical features
 Localized, lobular, non-tender
 Semi-fluctuant
 Mobile
 Slip sign
 Skin free
 Pedunculated +/-

11. Complications
 Myxomatous degeneration
 Saponification
 Calcification
 Infection
 Ulceration
 Intussusception & intestinal obstruction

12. Liposarcoma
 Common in retroperitoneum, thigh & back
 Rapid growth
 Warm & vascular
 Dilated veins
 Restriction of mobility
 Skin fixation & fungation
 Hematogenous spread to lungs

13. Treatment
 Excision
 Liposarcoma- wide
excision, reconstruction, adjuvant chemo- &
radiotherapy

15. Thank you…