Lipoma natural history, complications and prognosis: Difference between revisions
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==Complications== | ==Complications== | ||
Lipomas are rarely life-threatening and the common subcutaneous lipomas are not a serious condition. Lipomas growing in internal organs can be more dangerous, for example lipomas in the gastrointestinal tract can cause bleeding, [[Peptic ulcer|ulceration]] and painful obstructions (so-called "malignant by location", despite being a benign growth histologically).<ref>{{cite journal |author=Thompson WM |title=Imaging and findings of lipomas of the gastrointestinal tract |journal=AJR Am J Roentgenol |volume=184 |issue=4 |pages=1163–71 |date=1 April 2005|pmid=15788588 |url=http://www.ajronline.org/cgi/pmidlookup?view=long&pmid=15788588 |doi=10.2214/ajr.184.4.01841163}}</ref><ref>{{cite journal |author=Taylor AJ, Stewart ET, Dodds WJ |title=Gastrointestinal lipomas: a radiologic and pathologic review |journal=AJR Am J Roentgenol |volume=155 |issue=6 |pages=1205–10 |date=1 December 1990|pmid=2122666 |url=http://www.ajronline.org/cgi/pmidlookup?view=long&pmid=2122666 |doi=10.2214/ajr.155.6.2122666}}</ref> Malignant transformation of lipomas into [[liposarcoma]]s is very rare and most liposarcomas are not produced from pre-existing benign lesions.<ref name=Dalal/> A few cases of malignant transformation have been described for bone and kidney lipomas,<ref>{{cite journal |author=Milgram JW |title=Malignant transformation in bone lipomas |journal=Skeletal Radiol. |volume=19 |issue=5 |pages=347–52 |year=1990 |pmid=2165632 |doi=10.1007/BF00193088}}</ref><ref>{{cite journal |author=Lowe BA, Brewer J, Houghton DC, Jacobson E, Pitre T |title=Malignant transformation of angiomyolipoma |journal=J. Urol. |volume=147 |issue=5 |pages=1356–8 |date=May 1992 |pmid=1569683}}</ref> but it is possible these few reported cases were well-differentiated liposarcomas in which the subtle [[malignant]] characteristics were missed when the tumour was first examined.<ref name=Enzinger08>{{cite book |author=Goldblum, John R.; Weiss, Sharon W.; Enzinger, Franz M. |title=Enzinger and Weiss's soft tissue tumors |publisher=Mosby Elsevier |year=2008 |isbn=0-323-04628-2 |edition=5th}}</ref> Deep lipomas have a greater tendency to recur than superficial lipomas, because complete surgical removal of deep lipomas is not always possible.<ref>{{cite book |author=Fletcher, C.D.M., Unni, K.K., Mertens, F. |title=Pathology and Genetics of Tumours of Soft Tissue and Bone |publisher=IARC Press |location=Lyon |year=2002 |isbn=92-832-2413-2 |series=World Health Organization Classification of Tumours |volume=4}}</ref> | |||
==Prognosis== | ==Prognosis== |
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Natural History
Complications
Lipomas are rarely life-threatening and the common subcutaneous lipomas are not a serious condition. Lipomas growing in internal organs can be more dangerous, for example lipomas in the gastrointestinal tract can cause bleeding, ulceration and painful obstructions (so-called "malignant by location", despite being a benign growth histologically).[1][2] Malignant transformation of lipomas into liposarcomas is very rare and most liposarcomas are not produced from pre-existing benign lesions.[3] A few cases of malignant transformation have been described for bone and kidney lipomas,[4][5] but it is possible these few reported cases were well-differentiated liposarcomas in which the subtle malignant characteristics were missed when the tumour was first examined.[6] Deep lipomas have a greater tendency to recur than superficial lipomas, because complete surgical removal of deep lipomas is not always possible.[7]
Prognosis
The outlook of lipoma is always good. Usually most lipomas will not transform into liposarcomas.
References
- ↑ Thompson WM (1 April 2005). "Imaging and findings of lipomas of the gastrointestinal tract". AJR Am J Roentgenol. 184 (4): 1163–71. doi:10.2214/ajr.184.4.01841163. PMID 15788588.
- ↑ Taylor AJ, Stewart ET, Dodds WJ (1 December 1990). "Gastrointestinal lipomas: a radiologic and pathologic review". AJR Am J Roentgenol. 155 (6): 1205–10. doi:10.2214/ajr.155.6.2122666. PMID 2122666.
- ↑
- ↑ Milgram JW (1990). "Malignant transformation in bone lipomas". Skeletal Radiol. 19 (5): 347–52. doi:10.1007/BF00193088. PMID 2165632.
- ↑ Lowe BA, Brewer J, Houghton DC, Jacobson E, Pitre T (May 1992). "Malignant transformation of angiomyolipoma". J. Urol. 147 (5): 1356–8. PMID 1569683.
- ↑ Goldblum, John R.; Weiss, Sharon W.; Enzinger, Franz M. (2008). Enzinger and Weiss's soft tissue tumors (5th ed.). Mosby Elsevier. ISBN 0-323-04628-2.
- ↑ Fletcher, C.D.M., Unni, K.K., Mertens, F. (2002). Pathology and Genetics of Tumours of Soft Tissue and Bone. World Health Organization Classification of Tumours. 4. Lyon: IARC Press. ISBN 92-832-2413-2.