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Q: Lipomas near peripheral nerves ( Answered,   0 Comments )
Question  
Subject: Lipomas near peripheral nerves
Category: Miscellaneous
Asked by: georgeramsay-ga
List Price: $50.00
Posted: 01 Feb 2003 00:37 PST
Expires: 03 Mar 2003 00:37 PST
Question ID: 155984
What is the incidence of benign lipomas adjacent to or within the
sheath of large peripheral nerves, specifically the sciatic nerve?
What are the treatment options?
What is the prognosis for each option?
Answer  
Subject: Re: Lipomas near peripheral nerves
Answered By: ladyd-ga on 01 Feb 2003 13:52 PST
 
Hi georgeramsay-ga, 

This was an interesting question because I have been told that I have
a lipoma too.  I looked up the definition of a Lipoma and according to
the World Book Medical Encyclopedia it is a non cancerous tumor made
up of fat.  These are generally located on the truck, head or
shoulders of the body.  They do not require treatment unless they are
causing problems such as pressing on a nerve, compromising a muscle or
for cosmetic reasons.  They are often located just under the skin but
can be found in organs such as the intestines or lung.

If a lipoma is causing a problem with nerves, such as in the spinal
area, a neurosurgeon should be consulted to determine the best course
of treatment.

"The World Book Medical Encyclopedia" defines a lipoma here:
http://www.rush.edu/worldbook/articles/012000a/012000086.html

This is an excellent article on lipomas.
“What Are Lipomas?” 
American Academy of Family Physicians
http://www.aafp.org/afp/20020301/905ph.html


“ORTHOTEERS SYLLABUS” offers soft tissue classification, including
lipomas and peripheral nerve tumours.  This does include benign and
malignant listings.
You can find that article here: 
http://www.orthoteers.co.uk/Nrujp~ij33lm/Orthtumsofttissue.htm#Benign_fatty

Lipmas are not malignant but there are Liposarcomas.  These should not
be confused with a lipoma, as lipomas do not become cancerous.  This
is explained very well in this article on Mediscape:

“MSTS Examines New and Conventional Technologies for Diagnosis of
Tumors”
http://www.medscape.com/viewarticle/413082
(Note:  All articles on Medscape are free to view but you will need to
register to access them.)

The incidence of lipomas are a bit vague because most of them do not
need treatment and therefore are not documented.  I listed the sites
that mention incidence here:

“Soft Tissue & Bone Tumors”
Dr. B. Wehrli, Pathology, LHSC, University Campus
http://www.uwo.ca/pathol/MedsI/Bone/tumors.html

Atlas of Genetics and Cytogenetics in Oncology and Haematology
“Lipoma / benign lipomatous tumors”
http://www.infobiogen.fr/services/chromcancer/Tumors/lipoma5050.html 

Treatment options include watching non symptomatic slow growing
lipomas, steroid shots, liposuction, or surgery.

The American Family Physician offers good information on Lipomas along
with excisional and nonexcisional treatment methods.
http://www.aafp.org/afp/20020301/901.html

The most common treatment I found was surgical intervention but I did
find a possible new treatment using an injection of the enzyme
collagenase.  It is very new and clinical trials on people just began
in June.  You will find this very interesting news article here:

“Enzyme Shows Early Promise in Fat Melting”
http://news.yahoo.com/news?tmpl=story2&cid=570&ncid=753&e=2&u=/nm/20021218/sc_nm/health_biospecifics_fatmelter_dc

Liposuction was never mentioned with any lipoma of the spinal area.  I
would bet that due to the delicate location if the tumor, this would
be a difficult and dangerous procedure.

The wait and see approach works as long as the lipoma is not
interfering with other organs, causing pain or other problems.

Surgery is recommended when the lipoma is causing nerve problems, pain
etc.  Basically what they do is do is a resection, (removing the
lipoma).
This article talks specifically about Spinal Lipomas, defines the
different types, their classifications, surgical treatment,
complications and follow-up.

“Spinal Lipomas”
located on Medscape 
http://www.medscape.com/viewarticle/405673_1

Here are a few more that I found that offer treatment information and
prognosis:

Articles from eMedicine
“Neurilemmoma”
http://www.emedicine.com/orthoped/topic524.htm

“Lipomas”
http://www.emedicine.com/DERM/topic242.htm

“Lipomas”
http://www.emedicine.com/med/topic2720.htm

I thought you would find this interesting because this woman was
ultimately diagnosed with a lipoma in the sciatic notch region.  She
had surgical intervention, more specifically, a 'surgical resection'. 
Resection is mentioned in some of the articles above.

“Buttock And Lower Extremity Pain”
http://daffodil.uthscsa.edu/faculty/dumitru/emgs/plexopathies/lumbosacral/buttock.html

If a tumor is located in the spinal area, you may wish to consider a
consultation with a highly experienced neurosurgeon or a neurologist. 
Any surgery has its risks and the best thing any one can do is to
become as informed as possible.  Ask the physician every single
question that can be thought of.  No question is a foolish one when it
comes to a persons health.

Search Strategy Included variations of the following list of words:  
Lipoma Treatment options, peripheral nerves, sciatic nerve, incidence,
soft tissue tumor, complication risks, liposuction, surgery

Please let me know if I can be of further help and good luck.
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