- Lipomas are the most common benign soft tissue tumors, occurring as localized or diffuse masses of fatty tissue that can develop anywhere on the body except the brain. Clinical features include a soft, lobular, movable mass that is non-tender and often fluctuant. - Dermoid cysts contain tissues such as hair follicles, sebaceous glands and sweat glands. Sebaceous cysts form due to blockage of sebaceous glands, containing a cheesy material within a cyst wall. Ganglions occur near tendons or joints and contain clear fluid. Proper diagnosis of soft tissue swellings requires determining their origin and type.

1. Swellings & cysts
-Dr M Srinivas,
Assistant prof.,
General Surgery Dept.,
NRIIMS

2. Swelling
(or)
mass
(or)
lump

3. Diagnosis of swelling
• Origin from?
• Type of swelling(c,i,n,t,o)
Congenital-hemangioma,meningocele,cystic
hygroma....branchial cyst,dermoid
cyst,thyroglossal cyst

4. lipoma
• most common benign tumour
• hyperplasia or combo of neoplasm &
hyperplasia
• universal tumour (ubiquitous tumour) as it
can occur anywhere in the body except brain

5. • localised (encapsulated) or diffuse
(nonencapsulated)
• superficial or deep
• single or multiple Multiple lipomas are 15%
common; males(6:1).
common in back, shoulder and upper arm;
can be symmetrical
can be associated with many syndromes like
multiple endocrine neoplasia (MEN),Cowden’s,
Frohlich, Proteus, Bannayan-Zonana syndromes

8. Clinical features
• lobular (surface), nontender
• Often fluctuant & usually nontransilluminant
• Mobile, with edges slipping between the
palpating fingers (slip sign)
• Skin is free
• Pedunculated at times
• Pain
• Trunk is the most common site; nape of neck
and limbs are next common.

9. Slip sign

13. Fluctuation test(if +fluid in swelling)

16. Dermoids
• types-sequestration,
tubuloid(thyroglossal,ependymal,urachal,post anal)
implantation,
teratomatous
• Dermoid cyst contains putty like desquamated
material,hair follicle, sebaceous and sweat
glands & lined by both dermal and epidermal
components

20. Sebaceous cyst/Epidermoid cyst
• retention cyst
• It is due to blockage of the duct causing a
cystic swelling
• Sebaceous glands are situated in dermis which
secretes sebum through sebaceous duct
which opens either directly to skin surface or
in to a hair follicle

23. • common in face, scalp, scrotum
• not seen in palms and soles??
• contains yellowish white cheesy material with
fat and epithelium & has putty like consistency
• parasite in the wall of the sebaceous cyst—
Demodex folliculorum

24. c/f
• Painless swelling which is smooth, soft,
nontender
• Freely mobile, adherent to skin especially over
the summit, fluctuant(positive Paget’s test),
nontransilluminating with punctum over the
summit(70%)
• moulds on finger indentation.

28. • Multiple sebaceous cysts may be associated
with syndromes like Gardner’s syndrome

29. Cocks peculiar tumour resembling
epithelioma(infected sebaceous cyst
causing fungating like mass)

30. papilloma
• warty swelling from the skin or often from the
mucous membrane
• has got a central axis of connective tissue,
blood vessels & lymphatics

32. Fibroma(benign tumour arising
from fibrous tissue/capsulated)

33. NEUROFIBROMA
• benign tumour arising from connective tissue
of the nerve containing ectodermal, neural
and mesodermal connective tissue
components

35. Lingual schwannoma

36. Ganglion
• cystic swelling occurring in relation to tendon
sheath or synovial sheath or joint capsule
• contains clear gel like fluid
• high recurrence rate (30%). After excision
always it should be sent for histopathology

38. Glomus tumour

39. Ranula