Surgery for a soft tissue tumor - Buda Health Center

In case of soft tissue tumors, the definite diagnosis is often given by the histopathological analysis after the surgery. The most common soft tissue changes are lipomas, suture granulomas, and endometriosis.

Lipoma

What is a lipoma?

A lipoma is a benign neoplasm, which develops from fat cells. Lipomatosis is a condition with the simultaneous occurrence of multiple lipomas due to a genetic mutation, and it often shows familial aggregation. In extreme cases, a lipoma can grow up to weighing several kilograms, and lipomatosis means that several hundreds of lipomas develop all of the body.

Symptoms of lipomatosis

A flexible, usually well defined, painless lump develops at some part of the body, usually on the trunk or the limbs. It grows slowly, and it may cause symptoms due to its size and location, even though that is rare. The most common symptoms are pressure sensitivity, pain, and numbness due to the compression of the nerves or vascular structures, in the case of which, disturbances in the blood flow may develop. In extreme cases, it can develop even in the heart and the salivary glands as part of certain syndromes.

Suture granuloma

What is suture granuloma?

Suture granuloma is a chronic inflammatory process, which develops around surgical sutures. The granuloma is the body’s protective reaction, a benign process which starts as a consequence of a foreign body, or an antigen which was identified as foreign.

The causes of suture granuloma

Foreign body reaction in the tissues is caused by materials used in the past, or non absorbable surgical sutures.

The symptoms of suture granuloma

In one part of the cases, a painless swelling develops, and it is more common that the commencing inflammatory reaction causes symptoms such as skin redness, swelling, pain, and discharge.

Endometriosis

What is endometriosis?

Endometrium is the Latin name of the uterine lining. Endometriosis is a disease or condition, where islands of uterine lining develop outside of the uterine cavity too. This could be:

Genital i.e., the one which affects the genitals e.g., the fallopian tubes
Extragenital e.g., in the intestines, on the peritoneum

Symptoms of endometriosis

Endometriotic islands react to hormonal changes the same way as the urine lining does.
This means that the swell and bleed during menstruation. They cause swelling, and many times the development of the so called chocolate cyst in the fallopian tubes and the ovaries, which is painful; and dysmenorrhea is typical i.e., intensive abdominal pain and pain in the lesser pelvis. When they can be found on the peritoneum, free abdominal fluid can be observed in the abdominal ultrasound image, and when the bowel is involved, they cause rectal bleeding. Following a laparoscopic surgery that is performed due to endometriosis, the endometrial cells may get into the abdominal wall at the location of the incision, and they could periodically induce swelling and pain. In one part of the cases, endometriosis is confirmed as the cause of infertility. Removing the endometriotic islands present in the abdominal wall is performed as an outpatient surgical procedure.

Treating soft tissue tumors

The diagnosis of soft tissue tumors

Physical examination is performed in the first line, which should be complemented by ultrasound scan or other imaging studies. In certain cases, an ultrasound guided tissue biopsy, or other imaging studies might be necessary too. Every removed tissue sample will be sent for a histopathological analysis, which will provide the definite diagnosis. If a malignant tumor is confirmed, further treatments might become necessary.

The treatment of soft tissue tumors

Surgical removal. If the continuity of the abdominal wall is disrupted during the removal, the reconstruction of the abdominal wall, or even the implantation of a mesh might become necessary too. This is common with endometriosis or suture granuloma, but the placement of an implant is contraindicated if inflammation is present.