Dev Lipomların Cerrahi Tedavisi Sonrası Klinik Sonuçlar: Tek Merkez Deneyimi

Öz

Amaç: Lipomlar iyi huylu tümörlerdir ve genellikle küçük lezyonlar olarak ortaya çıkar. Ancak dev lipomlar daha az sıklıkta görülür. Dev lipomların cerrahi tedavisi ile ilgili çok az sayıda çalışma bulunmaktadır. Marjinal veya geniş rezeksiyon genellikle uygulanmaktadır; ancak standart bir cerrahi yaklaşım yoktur. Bu çalışmanın amacı, dev hücreli lipomların cerrahi tedavisi sonrası klinik sonuçlarını değerlendirmek ve lipomatöz tümörlerin ayırıcı tanısını sunmaktır. Gereç ve Yöntemler: Bu çalışmaya 2015 ve 2020 yılları arasında en az 10 cm çapında dev lipom nedeniyle kliniğimize başvuran toplam 42 olgu (24 kadın, 18 erkek) dahil edildi. Tüm olgulara ameliyat öncesi biyopsi uygulandı. Tüm hastalara geniş eksizyon yapıldıktan sonra postoperatif histopatolojik inceleme yapıldı. Bulgular: Ortalama yaş 57,5±12,9 yıl idi. Ortanca takip süresi 35 aydı. Anatomik yerleşim 16 (%38,1) hastada uyluk, 7 (%16,7) hastada omuz, 5 (%11,9) hastada kalça, 4 (%9,5) hastada sırt, 9 (%21,4) hastada kol, 1 (%2,4) hastada iliak bölge idi. Geniş rezeksiyon yapıldı ve nihai patoloji sonucu tüm hastalarda lipom ile uyumluydu. Proksimal femurda yerleşimli dev lipomun çıkarılmasından sonra bir hastada geçici nöropraksi görülmesi dışında başka bir komplikasyona rastlanmadı. Son kontrolde, tüm hastalar asemptomatikti ve nüks görülmedi. Sonuç: Dev lipomların teşhisinde ameliyat öncesi biyopsi ve tedavisinde geniş rezeksiyon tercih edilmelidir. Geniş rezeksiyon rekürrensi önleyebilir. Muhtemel malign transformasyonun tespit edilmesi için rutin takip gereklidir.

Anahtar Kelimeler

• dev lipom
• geniş rezeksiyon
• iyi huylu tümör

Clinical Results of Surgical Treatment of Giant Lipomas: A Single-Center Experience

Abstract

Aim: Lipomas are benign tumors, and generally present as small lesions. However, giant lipomas are less frequent. There are only a few studies regarding the surgical treatment of giant lipomas. Marginal or wide resection is usually performed; however, there is no standard surgical approach. The aim of this study was to evaluate clinical results after surgical treatment of giant lipomas and to present a differential diagnosis of lipomatous lesions. Material and Methods: A total of 42 cases (24 female, 18 male) admitted to our clinic between 2015 and 2020 due to giant lipoma with at least 10 cm dimensions were included in this study. A preoperative biopsy was performed for all cases. All patients were undergone wide excision followed by postoperative histopathological examination. Results: The mean age was 57.5±12.9 years. The median follow-up was 35 months. Anatomic localization was thigh in 16 (38.1%) patients, shoulder in 7 (16.7%) patients, hip in 5 (11.9%) patients, back in 4 (9.5%) patients, arm in 9 (21.4%) patients, and the iliac region in 1 (2.4%) patient. Wide resection was performed, and final pathology was consistent with lipoma in all cases. There was no complication except in one patient who had transient neuropraxia after removing a giant lipoma at the proximal femur. At the latest follow-up, all cases were asymptomatic with no recurrence. Conclusion: Preoperative biopsy and wide resection should be preferred for the diagnosis and treatment of giant lipomas. Wide resection may prevent a recurrence. Routine follow-up is necessary to detect possible malign transformation.

Keywords

• giant lipoma
• wide resection
• benign tumors

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