Lipoma | Benign Fatty Lumps | Examples, Diagnosis & Treatment

What is a lipoma?

A lipoma is a soft fatty lump. It is a non-cancerous (benign) growth made up from fat cells that clump together. A lipoma can occur in any part of the body where there are fat cells.

Superficial subcutaneous lipoma

By Jmarchn (Own work), via Wikimedia Commons

Jmarchn, CC BY-SA 3.0, via Wikimedia Commons

Lipomas typically feel soft and can be felt to move slightly under your skin when you press on them.

Lipomas under the skin are the most common

Lipomas often form in the fatty tissue under the skin. These are also the most noticeable ones, as they look and feel like soft, dome-shaped lumps under the skin. They vary in size from pea-sized to several centimetres in diameter. The most common sites where lipomas develop are on the shoulders, the chest and the back. However, other areas of the skin can develop a lipoma.

Other parts of the body

Lipomas can less commonly form inside the body too. However, in most of these cases you will not be aware that you have a lipoma, as you cannot see them and they rarely cause any problems.

Who develops lipomas and how common are they

Anyone can develop a lipoma at any age. Lipomas are common. Some people inherit a tendency to develop lipomas and may have several on different parts of the body. Sometimes as many as 20 or more develop. However, it is more common to develop just one or two.

Lipomas can occur in people who are normal weight as well as in people who are overweight.

What are the symptoms of a lipoma and are they harmful?

In themselves, lipomas are not serious and most lipomas cause no symptoms or problems. Usually if you have a lipoma, it does not cause any symptoms but you notice a painless lump. Lipomas grow very slowly. Sometimes a lipoma under the skin can be unsightly if it grows to be several centimetres across. Rarely, a lipoma may press on another structure and cause problems. For example, if one presses on a nerve it may cause pain. Also, rarely, a lipoma may develop in the gut wall and cause problems such as pain or a blockage of the gut.

Sometimes a scan or other investigation that is done for other reasons may detect a lipoma inside the body by chance. There is a condition called familial multiple lipoma in which groups of fat cells occur under the skin and then produce multiple fatty lumps. This is an uncommon condition and runs in families.

Note: lipomas are always benign. There is no scientific evidence that a lipoma increases the risk of developing a cancer in the future. However, lipomas can sometimes be mistaken for a cancerous tumour called a liposarcoma. These are usually large (5 cm or more in diameter) and grow rapidly. If you are concerned about a lipoma which has started to increase in size you should consult your doctor.

Do I need any tests?

Often your doctor will be able to diagnose a lipoma from its typical appearance, and no tests will be needed. In some cases, a scan may be needed to confirm whether your lump is a lipoma. This may be:

Do I need any treatment for a lipoma?

Usually not. If you are not bothered by a lipoma that develops then it is best just to leave it alone. However, some people want lipomas that are unsightly to be removed for cosmetic reasons. For example, if they occur on the face.

Occasionally, a lipoma needs to be removed if it is causing symptoms – for example, by pressing on another part of the body. Sometimes if the diagnosis is not clear, a lipoma is removed to look at under the microscope. This is to make sure the growth that has been detected is a lipoma and not something more serious.

For a lipoma that forms under the skin, usually it can be removed by a simple minor operation. Some local anaesthetic is injected into the skin over the lipoma. Once the overlying skin is numbed by the local anaesthetic, a cut (an incision) is made over the lipoma. The lipoma is then removed and cut away from the underlying tissue. The wound is then stitched up. A fine scar will be left.

Steroid injections and liposuction are sometimes used as alternatives to surgery.

Giant lipomas of the upper extremity

Can J Plast Surg. 2007 Autumn; 15(3): 141–144.

Language: English | French

, MD,^1,2, MD,^1,2 and , MD¹

Brian Allen

¹Hartford Hospital, Hartford, Connecticut, USA

²University of Connecticut, Farmington, Connecticut, USA

Christine Rader

¹Hartford Hospital, Hartford, Connecticut, USA

²University of Connecticut, Farmington, Connecticut, USA

Alan Babigian

¹Hartford Hospital, Hartford, Connecticut, USA

¹Hartford Hospital, Hartford, Connecticut, USA

²University of Connecticut, Farmington, Connecticut, USA

Correspondence: Dr Brian Allen, 85 Seymour Street, Hartford, Connecticut 06106, USA. Telephone 860-548-7338, fax 860-524-2654, e-mail
ude.chcu.tnediser@nellArBCopyright © 2007, Pulsus Group Inc. All rights reservedThis article has been cited by other articles in PMC.

Abstract

Lipomas are slow-growing soft tissue tumours that rarely reach a size larger than 2 cm. Lesions larger than 5 cm, so-called giant lipomas, can occur anywhere in the body but are seldom found in the upper extremities. The authors present their experiences with eight patients having giant lipomas of the upper extremity. In addition, a review of the literature, and a discussion of the appropriate evaluation and management are included.

Keywords: Giant lipoma, Liposarcoma, Upper extremity

Résumé

Les lipomes sont des tumeurs des tissus mous à croissance lente qui atteignent rarement plus de deux centimètres. Des lésions de plus de cinq centimètres, qu’on appelle lipomes géants, peuvent se former n’importe où sur le corps, mais on les observe rarement sur les membres supérieurs. Les auteurs présentent leur expérience auprès de huit patients ayant un lipome géant d’un membre supérieur. L’article inclut une analyse bibliographique et un exposé de l’évaluation et de la prise en charge pertinentes.

Lipomas are the most common mesenchymal tumour. They are believed to arise from primordial adipocytes, not from adult fat cells, therefore increasing in size as a patient accumulates adipose tissue but not decreasing with weight loss. They usually develop as well-circumscribed, encapsulated masses that have a doughy feel and are freely mobile beneath the skin. Lipomas can occur in many locations, but occur most commonly in the subcutaneous tissue of the head, neck, shoulders and back. They can also be found intermuscularly, intramuscularly, interosseously, associated with viscera or at a site of prior trauma. Subtypes include conventional lipomas, fibrolipomas, angiolipomas, spindle cell lipomas, myelolipomas and pleomorphic lipomas. Their slow, usually painless growth can lead to a large size at presentation, especially when located in deep subfascial planes.

Cosmetic deformity or compressive symptoms usually bring lipomatous masses of the upper extremity to medical attention earlier than rapidly growing masses in other locations of the body. Previous studies have defined a giant lipoma of the upper extremity as larger than 5 cm in any one dimension; a tumour of this size warrants a work-up for malignancy (1). Giant lipomas of the upper extremity are rare, but when they occur, an appropriate workup must be done. This should be followed by adequate open surgical excision and repeat examination over time to monitor for recurrence.

CASE PRESENTATIONS

A series of eight consecutive patients, four male and four female, who were evaluated at Hartford Hospital, Connecticut, USA from 2003 to 2007 with giant lipomatous masses of the upper extremity is presented. The patients ranged in age from 15 to 70 years with a mean age of 53 years (). The tumours ranged from 14 cm ×12 cm × 2 cm to 5 cm × 4 cm × 2 cm in size. Each patient underwent excision of the mass with primary closure. Specimens were sent to pathology postoperatively. Seven of the eight patients had benign lipomas; patient 5 had a well-differentiated liposarcoma. Four cases are presented here in more detail.

TABLE 1

Patient 2

A 63-year-old man presented with a mass on his right forearm. The patient reported having a ‘fatty tumour’ removed from the same location two years earlier in Puerto Rico. He had noticed recurrence of the mass approximately one year after the initial surgery, and magnetic resonance imaging (MRI) had revealed a mass between the brachioradialis and supinator muscles of the right arm, suspicious for lipoma. He had elected to observe the mass at that time but at presentation reported the lesion to be larger than ever, and complained of new-onset pain and tenderness in his right forearm with motion in his elbow. Physical examination revealed a scar from the previous excision on the volar aspect of his forearm. A mildly tender mass was palpated just below the scar. Sensation and motor function were intact throughout his right hand and forearm.

A repeat MRI two years after the initial excision demonstrated a mass with homogeneous fat signal volar to the brachioradialis, and posterior and radial to the pronator teres muscle. At this time, the patient underwent a radical excision of a 4 cm × 3 cm × 2 cm mass with primary closure. Final pathology revealed a lipoma.

The patient later returned, complaining of recurrance of the mass. Physical examination revealed a 3.5 cm × 3.2 cm mildly tender, well-circumscribed subcutaneous mass just proximal to the most recent incision. When palpated, the patient reported numbness and tingling in the ulnar distribution of his fingers. A repeat MRI did not demonstrate recurrence of the fatty lesion; however, a re-exision was performed primarily for symptomatic relief. Radical excision of a 4 cm × 3 cm × 1 cm mass with primary closure was achieved. Final pathology revealed a recurrence of his lipoma.

Patient 4

A 15-year-old girl presented with a mass on her left forearm. She had first noticed the lesion four years earlier and reported that it had been steadily enlarging over the previous two months. On examination, there was a spongy, ill-defined mass covering nearly the entire volar aspect of her left forearm. There were no overlying skin changes, and her left arm had intact neurovasculature.

MRI revealed a large, well-circumscribed, homogeneous fatty mass. The lesion was located intramuscularly, within and volar to the extrinsic flexor muscles of the left hand (). There was no postgadolinium enhancement of the lesion. A radical excision and primary closure were performed (). The mass was sent to pathology intraoperatively and revealed a 14 cm × 12 cm × 2 cm lipoma. Postoperatively, the patient recovered well with no functional deficits.

Patient 4. Preoperative magnetic resonance imaging showing a large fatty mass volar to the flexor muscles of the left hand

Patient 4. Intraoperative images of the excision. Final pathology revealed a 14 cm × 12 cm × 2 cm lipoma

Patient 5

A 53-year-old woman presented, complaining of recent spontaneous rapid growth of a mass in her right forearm. This lesion had been previously biopsied by a surgical oncologist, revealing a lipoma with myxoid change. On physical examination, she had an obvious mass on her right forearm. The lesion was well circumscribed and appeared somewhat fixed to deeper tissues. Her forearm and hand had intact neurovasculature, with no compromise in motor function due to the mass.

MRI revealed a mass within the brachioradialis muscle of the right arm. The mixed fatty and soft tissue density of the mass, along with the postgadolinium enhancement and deep location, was suspicious for liposarcoma (). The patient underwent radical excision of a 12 cm × 6 cm × 2 cm well-encapsulated mass that was adherent to the muscle on the dorsal aspect of the lesion (). Primary closure was achieved. Final pathology revealed a well-differentiated liposarcoma. The patient healed well with no complications.

Patient 5. Preoperative T1- and T2-weighted magnetic resonance image showing a mass within the right brachioradialis muscle

Patient 5. Intraoperative images of the excision. Final pathology revealed a 12 cm × 6 cm × 2 cm well-differentiated liposarcoma

Patient 7

A 61-year-old man being followed for a foot wound reported the growth of a mass in his left triceps over the previous several weeks. The mass was nontender, and he recalled no antecedent trauma. On physical examination, a deep, well-circumscribed mass was palpated in the region of the left triceps. The mass was freely movable, with no overlying skin changes.

MRI revealed a mass within the left triceps consistent with a low-grade lipomatous lesion, likely an intramuscular lipoma (). Of note, there was mild fatty atrophy seen within the biceps muscle, likely related to remote injury. The patient underwent radical excision of the lesion, which was found to be 10 cm × 6 cm × 3 cm in size (). Final pathology revealed lipoma.

Patient 7. Preoperative magnetic resonance image showing an 11 cm × 2.9 cm oval-shaped mass located intramuscularly in the left triceps

Patient 7. Intraoperative images of the excision. Final pathology revealed a 10 cm × 6 cm × 3 cm lipoma

DISCUSSION

Most lipomas are benign and can occur alone or in multiple locations. There is a report (2) of an individual having as many as 160 individual lesions. Lipomas can arise spontaneously or as part of a syndrome such as hereditary multiple lipomatosis, adiposis dolorosa, Gardner’s syndrome and Madelung’s disease (3). Lipomas occur more frequently in female patients, presumably due to their tendency to accumulate more adipose tissue; however, we did not observe this trend in our series.

Lipomas usually grow at a very slow rate, and the etiology of rapid growth into giant lipomas is still a matter of debate. It has been suggested that blunt trauma can cause rupture of the fibrous septa and anchorage connections between the skin and deep fascia, allowing the adipose tissue to proliferate (4). Although the patient 7 denied any trauma to the area, there was evidence of remote injury to the left upper extremity on MRI. This may have led to the eventual rapid growth of an already existing intramuscular lipoma.

No matter the mechanism of rapid growth, the main concern when evaluating a giant lipoma in the upper extremity is to rule out malignancy. Liposarcomas are the most common soft tissue sarcomas, comprising 7% to 27% of all soft tissue sarcomas (5). They typically arise in the fourth to sixth decade of life. Liposarcomas consist of lipoblasts and may occur wherever fat is present, but are most commonly found within intramuscular fatty tissue. Histological subtypes of liposarcomas include well-differentiated, myxoid, round cell and pleomorphic liposarcomas. Well-differentiated liposarcomas exhibit low malignant potential, myxoid liposarcomas display intermediate malignant behaviour, and round cell and pleomorphic liposarcomas exhibit aggressive behaviour with early metastasis. Well-differentiated liposarcomas, as seen in patient 5, account for approximately 40% to 45% of liposarcomas (1). Recent rapid growth, size larger than 5 cm and intramuscular location have all been reported to be risk factors for malignancy (1,5,6).

Proper evaluation of a large mass in the upper extremity must include imaging or tissue sampling to rule out malignancy. MRI or biopsy are the two best options available. The possibility of an incompletely representative biopsy leading to misdiagnosis has led some to recommend MRI before attempting biopsy. On MRI, a lipoma appears as a mass with homogenous fat signal intensity surrounded by a pseudocapsule. Gadolinium-enhanced MRI has been reported to allow easy distinction of lipomas from well-differentiated liposarcomas due to increased levels of vascularity seen in septal structures within the lesion (7). High-grade liposarcomas have little fat on imaging, and dedifferentiated liposarcomas show obvious changes from a low-grade to high-grade tumour within the lesion (8). Ultrasound- or computed tomography-guided biopsy can then be used to target areas of radiological concern. Ultimately, surgical excision should be performed, possibly followed by radiation and chemotherapy. If a lipoma is incompletely excised, it may recur, as was seen in patient 2, who had had a lipoma removed from the same location two years previously. Liposarcomas are notorious for local recurrence, and even with attempted total resection, local recurrence rates may be as high as 50% (1).

Suction-assisted lipectomy has been suggested as a treatment option for giant lipomas, but the need for complete removal to prevent recurrence, along with the inability to predict where nerves and other vital structures have been displaced, renders this mode of treatment less attractive.

The proper management of giant lipomas is open excision. Lipomas are usually well encapsulated, allowing relatively straightforward complete removal. Intramuscular location makes removal more technically challenging and may require removal of some surrounding muscle to ensure adequate margins. Finally, a full pathology report on the specimen is required to determine the possible need for further treatment.

CONCLUSIONS

All lipomas in the upper extremities measuring larger than 5 cm in a single dimension should be surgically removed due to malignant potential. Preoperatively, imaging is important to delineate the extent of the lesion and to assist in operative planning. We recommend MRI for its ability to discern tissue planes. Surgical removal of lipomas may require significant dissection and mobilization of neurovascular structures for successful resection, and preoperative discussions with patients regarding potential loss of function are essential. Any lipomatous mass may recur with incomplete excision, and liposarcomas may require a larger repeat excision, chemotherapy or radiation.

REFERENCES

1. Cribb GL, Cool WP, Ford DJ, Mangham DC. Giant lipomatous tumours of the hand and forearm. J Hand Surg [Br] 2005;30:509–12. [PubMed] [Google Scholar]2. Phalen GS, Kendrick JI, Rodriguez JM. Lipomas of the upper extremity. A series of fifteen tumors in the hand and wrist and six tumors causing nerve compression. Am J Surg. 1971;121:298–306. [PubMed] [Google Scholar]4. Terzioglu A, Tuncali D, Yuksel A, Bingul F, Aslan G. Giant lipomas: A series of 12 consecutive cases and a giant liposarcoma of the thigh. Dermatol Surg. 2004;30:463–7. [PubMed] [Google Scholar]5. Celik C, Karakousis CP, Moore R, Holyoke ED. Liposarcomas: Prognosis and management. J Surg Oncol. 1980;14:245–9. [PubMed] [Google Scholar]6. Silistreli OK, Durmus EU, Ulusal BG, Oztan Y, Gorgu M. What should be the treatment modality in giant cutaneous lipomas? Review of the literature and report of 4 cases. Br J Plast Surg. 2005;58:394–8. [PubMed] [Google Scholar]7. Yang YJ, Damron TA, Cohen H, Hojnowski L. Distinction of well-differentiated liposarcoma from lipoma in two patients with multiple well-differentiated fatty masses. Skeletal Radiol. 2001;30:584–9. [PubMed] [Google Scholar]8. Ilaslan H, Sundaram M. Advances in musculoskeletal tumor imaging. Orthop Clin North Am. 2006;37:375–91. [PubMed] [Google Scholar]

Do I Need To Worry About My Lipoma?: Johnny L. Serrano, D.O., F.A.C.O.S: Board Certified General Surgeon

A lipoma is an abnormal fatty bump that typically develops within the subcutaneous layer of fat just beneath the skin. As one of the most common benign soft tissue growths, lipomas are not cancerous and aren’t likely to become malignant as time goes on.   

Given that most lipomas are small, painless, and totally harmless, treatment is rarely required. Some people opt to have the rubbery bulge removed if it’s bothersome, prominent, or they don’t like how it looks. 

As a board-certified general surgeon who specializes in lipoma evaluation and excision, Johnny L. Serrano, DO, FACOS, offers in-office lipoma removal at Precision Surgery and Advanced Vein Therapy in Glendale, Arizona. Here’s what you should know. 

Understanding lipomas

A lipoma is a noncancerous tumor made up of fat cells that have accumulated into an obvious bump or mound. While a lipoma can occur in any part of your body, most appear in the layer of fatty tissue that’s situated between your skin and your muscles. The average lipoma is:  

Located just under the skin 

Most lipoma growths are subcutaneous, or located just beneath the skin. They’re conspicuous because they push outward toward the dermal layer, rather than inward toward muscle tissue. Lipomas commonly appear along the neck, shoulders, back, abdomen, arms, or thighs. 

Soft, rubbery, and yielding  

Unlike the average cancerous tumor that can been seen or felt along the outside of your body, lipomas are not firm or hard — they’re soft and pliable to the touch, and they move easily with a gentle push of the finger. 

Relatively small and stable

Lipomas tend to grow slowly, often developing over a period of several months or years. Most stay relatively small, measuring less than two inches across. Most also remain stable, meaning they don’t continue growing once they’ve reached their apparent size. 

Rarely uncomfortable or painful

A typical lipoma isn’t painful to the touch or uncomfortably taut. Most people aren’t bothered by having one, apart from its appearance.  

Although lipomas can occur at any age, most form during middle age. The majority of people who develop a lipoma have a single growth, but one in five people with lipomas have multiple growths.  

Lipoma removal factors

Given that most lipomas are neither painful nor harmful, they generally don’t require treatment of any kind — after an evaluation confirms they’re totally benign, they’re usually left alone. 

That doesn’t mean you can’t decide to have a lipoma surgically removed, however. For those who opt to have this quick, in-office procedure, appearance is often their primary concern. The lipoma may be difficult to hide, or it may look prominent under certain clothes. 

People also choose to have lipomas removed if they’re atypical in some way. This includes:

Overly large size

Lipomas can grow as large as eight inches across, and some lipomas continue growing as time goes on. Apart from obvious cosmetic concerns, an overly large lipoma can be bothersome or constraining, depending on where it occurs.       

Causes discomfort

Most lipomas are self-contained, meaning they don’t invade surrounding tissue. Unfortunately, they can still affect nearby tissues, nerves, and blood vessels.  

A lipoma may cause discomfort or pain if it has blood vessels running through it or if it presses on a nearby nerve; it may also interfere with muscle growth if it’s unusually deep.       

Awkward location

While many lipomas occur in locations that are easily hidden by clothes, some lipomas grow in plain sight. They can form on the temples or forehead, on the front of the neck, along the wrist or forearm, above or behind the knee, or even on the palm of the hand.  

Lipoma excision surgery

The thin, fibrous capsule that surrounds a lipoma makes surgical excision relatively simple. In most cases, Dr. Serrano can numb the area with a local anesthetic, make a small incision over the growth, and gently squeeze the lipoma out. 

Larger lipomas may require regional anesthesia to numb specific nerves prior to surgery. While liposuction can be a useful approach for larger lipomas, Dr. Serrano performs standard surgical excision whenever possible because it’s less likely to result in recurrence (regrowth).

To learn more about lipoma removal at Precision Surgery and Advanced Vein Therapy, call 602-393-1299 or use the easy online booking tool to schedule a visit with Dr. Serrano today. 

Is This Lump a Sarcoma? Lipoma? Learn the Difference

Jul 7, 2020

It’s easy to get the care you need.

See a Premier Physician Network provider near you.

Although their names sound alike, and at first glance they may look alike, sarcomas and lipomas are very different. One is common and usually harmless. The other is less common and potentially fatal. Matthew Doepker, MD, with Premier Surgical Oncology, explains.

What’s a Lipoma?

Lipomas are non-cancerous fatty tumors, commonly found on the neck, shoulders, back, abdomen, arms, and thighs. “We’re not sure what causes them, but they tend to run in families,” says Dr. Doepker. They’re especially common in people between the ages of 40 and 60, and are equally common in males and females.

Lipomas grow just beneath the skin, feel squishy to the touch, and can be pushed around a bit with pressure from your fingers. Although lipomas are rarely serious, if you have one (or several), you may decide to have them removed. They’re typically less than two inches in diameter, “but they can grow quite large, and sometimes cause discomfort and pain,” says Dr. Doepker. And they can be unsightly, which is another reason you may choose to have yours removed.

What’s a Sarcoma?

A sarcoma is a malignant (cancerous) tumor that begins in your muscle, fat, cartilage, connective tissue, blood vessels, or bones, says Dr. Doepker. “They usually appear on the arms, legs, or the trunk of the body. But sometimes a sarcoma will grow inside the abdomen. When inside the abdomen, they can get very large and cause pain, bloating, a change in bowel habits, and weight loss.”

Doctors aren’t sure what causes sarcoma, but they believe your risk is greater if you have family members who also have sarcoma. And if you’ve been exposed to radiation to treat another cancer, you have a slightly increased chance of developing sarcoma (less than 5 percent). 

A sarcoma can grow to five inches or more. “Unlike a lipoma, a sarcoma is firm,” says Dr. Doepker. “You typically can’t push it around. And they can be tender to the touch. If your sarcoma is growing near a nerve, it may invade the nerve and cause a tingling or burning sensation. If it was on your arm, for example, you could lose function of your arm.” 

Generally, sarcomas need to be surgically removed, Dr. Doepker explains. “If they are very large, or if they are invading a nerve or blood vessel, we may suggest radiation to help shrink the tumor first. Our goal is to remove the tumor completely and not leave any disease behind.” The earlier a sarcoma is found, the less likely it has spread, and the better the outcome. The five-year survival rate for someone with sarcoma is about 65 percent. “If a patient can come to surgery, have the tumor completely removed with no disease left behind, their survival rate can be very good.”

At a Glance: Sarcoma vs. Lipoma

When Should You See a Doctor?

“I always tell patients they are their own biggest advocate,” says Dr. Doepker. “If there is something you’re concerned about, come to the office and we’ll have a discussion about it. We’ll develop a treatment plan if needed.”

To learn more about sarcoma and lipoma, talk to your doctor or health care provider or search for a provider.

It’s easy to get the care you need.

See a Premier Physician Network provider near you.

Source: Matthew Doepker, MD, Premier Surgical Oncology; National Institutes of Health; American Cancer Society

Types of Foot Tumors | Fixing Feet PLLC

There are many different kinds of tumors that can grow on the feet or ankles, but there are certain types we treat more often at Fixing Feet Institute: ganglion cysts, vascular tumors, and fatty tumors.

Ganglion Cysts

Ganglion cysts can technically pop up anywhere on the body, but they are most common on the hands and feet. They are benign and are a lump of cells that are knotted together and grow beneath the surface of the skin. The cysts can appear on the top or bottom of the foot, but since they are benign, they are more uncomfortable than they are dangerous.

Vascular Tumors

These tumors can be benign or cancerous, and again, are not always just found on the feet. A type of vascular tumor that is often found on the base of the foot is a glomus tumor; they are rare, but benign. They are more common in women and individuals in their 40s and 50s and are characterized by a sensitivity to cold, localized tenderness, and severe intermittent pain.

Fatty Tumors

Lipomas are growths of fat cells usually found just below the skin. They can be found anywhere, but when it comes to feet they are normally on the bottom of the foot. Lipomas are the most common noncancerous soft tissue growth. The tumors are usually pretty small and almost rubbery feeling. They should not be painful and they grow very slowly.

The word “tumor” is so often associated with cancer, that many people forget that many tumors can be benign. If you suspect you have a tumor, it’s very important to visit your doctor right away so he they can examine it to be sure it is not cancerous. Remember to keep an eye out for any unusual growths that seem to be on the skin (rather than under it) as well: skin cancer can turn up anywhere, including the feet.

If you think that you may have a tumor on your foot or ankle, contact Fixing Feet Institute at 623-584-5556 or e-mail [email protected] to make an appointment.

Cosmetic, Medical, & Surgical Dermatologists

Lipomas, while harmless, are technically tumors. If you’ve recently located a lump that appears to be a lipoma, a visit to the doctor can help determine whether it’s worth worrying about. About one in a thousand people will develop a lipoma in their lifetime, and many of these never require removal or cause for concern. However, it’s best to get this confirmed by your doctor. 

At Associated Dermatologists, with locations in West Bloomfield, Commerce, Novi, and Berkeley, Michigan, our team of expert skincare providers can accurately diagnose your dermatological issue and provide any needed excision and biopsy for lipomas or cysts.

Lipomas 101 

Put simply, a lipoma is just a fatty tumor. They’re typically harmless and don’t require removal unless you’re self-conscious or bothered by it. Common characteristics of lipomas include being: 

• Located just under the skin
• Found on the arms, thighs, neck, back, and shoulders
• Around 5 centimeters (2 inches) in diameter
• Slow-growing 
• Doughy to the touch
• Easily moved with pressure 
• Rarely painful 

Lipomas can sometimes grow to concerning sizes or put pressure on the surrounding nerves, which can cause pain. However, they aren’t hard to the touch, discolored, or rapidly growing. If you have a tumor with these more serious characteristics, it’s best to get it examined immediately. 

Lipoma versus liposarcoma

While lipomas are small and harmless, liposarcomas are a form of sarcoma, or malignant growth. They typically occur deeper within the body, and if left untreated, they can grow larger and spread to other parts of the body. They are often painful, swollen, and might lead to changes in weight. 

If you can see and feel a small, soft growth right under the skin, it’s probably just a lipoma. However, if you’re experiencing concerning symptoms and feel lumps in your abdomen or thighs, a visit to the doctor is necessary. 

What you can do about lipomas 

As mentioned above, lipomas are harmless and often small. You can leave them alone, though you should keep an eye on these growths to make sure they don’t change in size or texture. 

If your lipoma is located in a noticeable place, is causing pain, or you just want it gone, you can discuss removing it with your doctor. Common removal techniques include: 

• Excision with a scalpel 
• Liposuction 

Your doctor will make sure the area is properly numb and clean before removing the lipoma.

Have you noticed a soft lump somewhere on your body? Get it checked out by the experts at Associated Dermatologists by calling the location closest to you, or request an appointment online.

What Is a Soft Tissue Sarcoma?

Cancer starts when cells start to grow out of control. Cells in nearly any part of the body can become cancer and can spread to other areas. To learn more about how cancers start and spread, see What Is Cancer?

There are many types of soft tissue tumors, and not all of them are cancerous. Many benign tumors are found in soft tissues. The word benign means they’re not cancer. These tumors can’t spread to other parts of the body. Some soft tissue tumors behave in ways between a cancer and a non-cancer. These are called intermediate soft tissue tumors.

When the word sarcoma is part of the name of a disease, it means the tumor is malignant (cancer). A sarcoma is a type of cancer that starts in tissues like bone or muscle. Bone and soft tissue sarcomas are the main types of sarcoma. Soft tissue sarcomas can develop in soft tissues like fat, muscle, nerves, fibrous tissues, blood vessels, or deep skin tissues. They can be found in any part of the body. Most of them start in the arms or legs. They can also be found in the trunk, head and neck area, internal organs, and the area in back of the abdominal (belly) cavity (known as the retroperitoneum). Sarcomas are not common tumors.

Sarcomas that most often start in bones, such as osteosarcomas, and sarcomas that are most often seen in children, such as the Ewing Family of Tumors and Rhabdomyosarcoma, are not covered here.

Types of soft tissue sarcomas

There are more than 50
different types of soft tissue sarcomas. Some are quite rare, and not all are listed here:

• Adult fibrosarcoma usually affects fibrous tissue in the legs, arms, or trunk. It’s most common in people between the ages of 20 and 60, but can occur in people of any age, even in infants.
• Alveolar soft-part sarcoma is a rare cancer that mostly affects young adults. These tumors most commonly start in legs.
• Angiosarcoma can start in blood vessels (hemangiosarcomas) or in lymph vessels (lymphangiosarcomas). These tumors sometimes start in a part of the body that has been treated with radiation. Angiosarcomas are sometimes seen in the breast after radiation therapy and in limbs with lymphedema.
• Clear cell sarcoma is a rare cancer that often starts in tendons of the arms or legs. Under the microscope, it has some features of malignant melanoma, a type of cancer that starts in pigment-producing skin cells. How cancers with these features start in parts of the body other than the skin is not known.
• Desmoplastic small round cell tumor is a rare sarcoma of teens and young adults. It’s found most often in the abdomen (belly).
• Epithelioid sarcoma most often starts in tissues under the skin of the hands, forearms, feet, or lower legs. Teens and young adults are often affected.
• Fibromyxoid sarcoma, low-grade is a slow-growing cancer that most often starts as a painless growth in the trunk or arms and legs (particularly the thigh). It is more common in young to middle aged adults. It is sometimes called an Evans’ tumor.
• Gastrointestinal stromal tumor (GIST) is a type of sarcoma that starts in the digestive tract. See Gastrointestinal Stromal Tumor (GIST) for more details.
• Kaposi sarcoma is a type of sarcoma that starts in the cells lining lymph or blood vessels. See Kaposi Sarcoma.
• Leiomyosarcoma is a type of cancer that starts in smooth muscle tissue. These tumors often start in the abdomen, but they can also start in other parts of the body, such as the arms or legs, or in the uterus (see Uterine Sarcoma).
• Liposarcomas are malignant tumors of fat tissue. They can start anywhere in the body, but they most often start in the thigh, behind the knee, and inside the back of the abdomen (belly). They occur mostly in adults between 50 and 65 years old.
• Malignant mesenchymoma is a rare type of sarcoma that shows features of fibrosarcoma and features of at least 2 other types of sarcoma.
• Malignant peripheral nerve sheath tumors include neurofibrosarcomas, malignant schwannomas, and neurogenic sarcomas. These are sarcomas that start in the cells that surround a nerve.
• Myxofibrosarcomas, low-grade are most often found in the arms and legs of elderly patients. They are most common in or just under the skin and there might be more than one tumor.
• Rhabdomyosarcoma is the most common type of soft tissue sarcoma seen in children. See Rhabdomyosarcoma.
• Synovial sarcoma is a malignant tumor of the tissue around joints. The most common locations are the hip, knee, ankle, and shoulder. This tumor is more common in children and young adults, but it can occur in older people.
• Undifferentiated pleomorphic sarcoma (UPS) was once called malignant fibrous histiocytoma (MFH). It’s most often found in the arms or legs. Less often, it can start inside at the back of the abdomen (the retroperitoneum). This sarcoma is most common in older adults. It mostly tends to grow into other tissues around the place it started, but it can spread to distant parts of the body.

Intermediate soft tissue tumors

These may grow and invade nearby tissues and organs, but they tend to not spread to other parts of the body.

• Dermatofibrosarcoma protuberans is a slow-growing cancer of the fibrous tissue beneath the skin, usually in the trunk or limbs. It grows into nearby tissues but rarely spreads to distant sites.
• Fibromatosis is the name given to fibrous tissue tumor with features in between fibrosarcoma and benign tumors such as fibromas and superficial fibromatosis. They tend to grow slowly but, often, steadily. They are also called desmoid tumors, as well as the more scientific name musculoaponeurotic fibromatosis or just aggressive fibromatosis. They rarely, if ever, spread to distant sites, but they do cause problems by growing into nearby tissues. They can sometimes be fatal. Some doctors consider them a type of low-grade fibrosarcoma; but others believe they are a unique type of fibrous tissue tumors. Certain hormones, like estrogen, make some desmoid tumors grow. Anti-estrogen drugs are sometimes useful in treating desmoids that cannot be completely removed by surgery.
• Hemangioendothelioma is a blood vessel tumor that is considered a low-grade cancer (meaning it grows slowly and is slow to spread). It does grow into nearby tissues and sometimes can spread to distant parts of the body. It may start in soft tissues or in internal organs, such as the liver or lungs.
• Infantile fibrosarcoma is the most common soft tissue sarcoma in children under one year of age. It tends to be slow-growing and is less likely to spread to other organs than adult fibrosarcomas.
• Solitary fibrous tumors are most often not cancer (benign) but can be cancer (malignant). Some start in the thigh, underarm, and pelvis. They can also start in the tissue surrounding the lung (called the pleura). Many tumors that were once called hemangiopericytomas are now considered solitary fibrous tumors.

Benign soft tissue tumors

Many benign tumors, or tumors that are not cancer, can start in soft tissues. These include:

• Elastofibromas: benign tumors of fibrous tissue
• Fibromas: benign tumors of fibrous tissue
• Fibrous histiocytomas: benign tumors of fibrous tissue
• Glomus tumors: benign tumors that occur near blood vessels
• Granular cell tumors: usually benign tumors in adults that often start in the tongue but can be found almost anywhere in the body
• Hemangiomas: benign tumors of blood vessels
• Hibernomas: benign tumors of fat tissue
• Lipomas: very common benign tumors of fat tissue
• Leiomyomas: benign tumors of smooth muscle that can be found anywhere in the body but are very common in the walls of the uterus where they are known as fibroids
• Lipoblastomas: benign fat tissue tumors most often seen in children
• Lymphangiomas: benign tumors of lymph vessels
• Myxomas: benign tumors that usually are in muscles but do not start from muscle cells
• Neurofibromas: tumors of nerve tissue that are usually benign. Neurofibromas of large nerves, such as those in the upper arms or neck can become cancer. Neurofibromas are very common in people with an inherited condition called neurofibromatosis (also called von Recklinghausen disease) They’re much less common in people without this condition.
• Neuromas: benign tumors of nerves that can be painful
• PEComas: a family of tumors made up of abnormal cells called perivascular epithelial cells. Although most of these tumors are benign, some rare PEComas are malignant (cancer). The most common types of PEComas are angiomyolipomas and lymphangioleiomyomas. Angiomyolipoma is a benign tumor that most often affects the kidney. Lymphangioleiomyomatosis (or LAM) is a rare disease of women in which the many lymphangioleiomyoma tumors grow into the lung tissue and interfere with lung function.
• Rhabdomyomas: benign tumors of skeletal and heart muscle
• Schwannomas (neurilemmomas): benign tumors of the cells that coat nerves
• Tenosynovial giant cell tumors (also called nodular tenosynovitis): benign tumors of joint tissue

Spindle cell tumors

Spindle cell tumor and spindle cell sarcoma are descriptive names used because the cells look long and narrow under the microscope. Spindle cell tumor is not a specific diagnosis or a specific type of cancer. The tumor may be a sarcoma, or it can be sarcomatoid — meaning another type of tumor (like a carcinoma) that looks like a sarcoma under the microscope.

Tumor-like conditions of soft tissue

Some changes in soft tissues are caused by inflammation or injury and can form a mass that looks like a soft tissue tumor. Unlike a real tumor, they don’t come from a single abnormal cell, they have limited ability to grow or spread to nearby tissues, and never spread through the bloodstream or lymph system to other parts of the body. Nodular fasciitis and myositis ossificans are 2 examples which affect tissues under the skin and muscle tissues, respectively.

Science: Science and technology: Lenta.ru

Japanese scientists from the University of Graduate Studies in Advanced Research (Kanagawa Prefecture) have revealed similarities in the mechanisms of evolution of a cancer tumor and a whole population of individual organisms. The research preprint is at the disposal of the Lenta.ru editorial office.

A cancerous tumor grows from a single cell, but its genetic makeup can change due to spontaneously occurring mutations. As a result, several subpopulations of cells are formed that differ from each other in alleles (gene variants).Some mutations are driver and accelerate tumor growth, others – “passengers” – have no effect, but spread along with the driver.

Related materials

00:03 – January 17, 2017

Alien inside

How cancer cells become invulnerable and slowly destroy a person

Scientists believe that the methods of population genetics, which studies genetic variability in large groups of organisms under the influence of evolution could be useful to investigate how various mutations make cancer aggressive and drug-resistant.Thus, it is possible to trace the development of individual subpopulations of cells and understand what contribution they make to tumor growth.

However, the validity of the population-based approach remained questionable, since fundamental differences may exist between cancer and a population of organisms. In the latter, for example, generations of animals replace each other, and the size of the group remains constant. Moreover, some organisms leave more offspring than others, because they have evolutionary advantages.However, cancer cells are continually dividing, and as a result, the size of the cancer grows exponentially. The effect of beneficial mutations in this case is irrelevant.

Scientists looked at a model of a rapidly growing population of cancer cells to find out how mutations accumulate in it. The researchers were able to deduce the frequency of individual alleles at the last stage of tumor development, assuming for simplicity that all mutations are “passengers” (that is, they do not accelerate tumor growth). They concluded that the population-based approach could be applicable to both cancer and a group of organisms.

According to scientists, the results obtained mean that the already known laws of distribution of mutations among animals can, with some reservations, be used to study the evolution of a malignant tumor.

Scientists have found out what foods cause cancer

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Scientists have found out what foods cause cancer

Scientists have found out what foods cause cancer – RIA Novosti, 03.03.2020

Scientists have found out which foods cause cancer

According to the World Health Organization, every sixth earthling dies of cancer.In 2018 alone, oncological diseases claimed 9.6 million … RIA Novosti, 03.03.2020

2018-12-01T08: 00

2018-12-01T08: 00

2020-03-03T13: 13

Science

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MOSCOW, Dec 1 & nbsp; & mdash; RIA Novosti, Alfiya Enikeeva. According to the World Health Organization, every sixth earthling dies of & nbsp; cancer. In & nbsp; 2018 alone, cancer claimed 9.6 million lives. In about a third of cases, cancer has developed due to improper diet, experts say. What products should & nbsp; be treated with & nbsp; caution & nbsp; & mdash; in & nbsp; material RIA Novosti. Sweet death “Sugar and & nbsp; artificial sweeteners & nbsp; & mdash; number one in the & nbsp; list of dangerous products.Excessive consumption of refined sugar can lead to & nbsp; chronic diseases of the endocrine, cardiovascular systems, and & nbsp; also cause obesity. Sugar substitutes, artificial colors and & nbsp; flavors, drinks and & nbsp; products containing them are very toxic. Penetrating through & nbsp; mucous membranes of the larynx and & nbsp; esophagus, they are able to start malignant cell growth, and & nbsp; not only cause obesity. Abuse of harmful products can lead to & nbsp; cancer of the throat, esophagus and & nbsp; stomach and & nbsp; other organs and & nbsp; systems ” university.Sugar is also dangerous & nbsp; because it contributes to the rapid growth of malignant neoplasms, Belgian scientists say. Cancer cells multiply by & nbsp; due to very rapid glycolysis (this is the name of the process of breaking down glucose without the participation of oxygen). Its speed in tumor cells can be two hundred times higher than in normal tissues. A byproduct of ultrafast glycolysis & nbsp; & mdash; 1,6-bisphosphate fructose & nbsp; & mdash; is able to activate special proteins produced by RAS genes.They, in & nbsp; turn, cause an even greater growth of the malignant tumor. It turns out a vicious “sugar” circle. According to a study by an international group of scientists, excessive sugar consumption can cause cancer of the rectum, breast and & nbsp; bladder, but & nbsp; can protect against glioma & nbsp; & mdash; one of the & nbsp; most common types of brain cancer or & nbsp; spinal cord. After analyzing the data of about & nbsp; million people, biologists found that a low concentration of sugar in & nbsp; blood and & nbsp; brain tissues is statistically associated with & nbsp; a high probability of developing a malignant tumor of the nervous tissue.Dangerous sausageAt the end of 2015, the International Agency for Research on Cancer (IARC) recognized sausage and processed meat products with & nbsp; proven carcinogenic activity. According to the IARC expert opinion, their regular use can lead to & nbsp; development of colorectal cancer & nbsp; & mdash; even 50 grams of processed meat per day increases the chances of getting cancer by & nbsp; 18 percent. “Semi-finished products, sausages, smoked meats, ham contain preservatives that are dangerous for & nbsp; health, a lot of salt and & nbsp; various chemicals.Therefore, if you regularly eat such food for & nbsp; breakfast, lunch and & nbsp; dinner, then it is quite possible to earn colon cancer “, & nbsp; & mdash; explained Natalya Sukortseva. In addition, the love of & nbsp; sausage and & nbsp; sausages can lead to & nbsp; development of breast cancer According to scientists from the University of Glasgow (UK). Researchers analyzed the diet of more than 270 thousand European women and & nbsp; the incidence of cancer. It turned out that one sausage in & nbsp; week increases the risk of malignant tumor by & nbsp; 15 percent.It is also harmful to eat a lot of red meat. Instead, scientists advise eating poultry or & nbsp; fish. Fatty, tasty, unhealthyFoods with a & nbsp; high fat content promote the appearance of aggressive malignant tumors and & nbsp; increase their growth rate almost & nbsp; a hundred times, experiments on genetically modified mice have shown. American scientists have disabled the gene encoding the Lpcat3 protein in rodents, which controls the synthesis of phospholipids in & nbsp; cell membranes.As a result, the level of cholesterol in the body of mice increased. This led to the & nbsp; rapid division of stem cells in the intestinal tissues and & nbsp; caused the growth of malignant tumors in & nbsp; laboratory animals. Researchers from the & nbsp; Massachusetts Institute of Technology (USA), in & nbsp; fed mice with fatty food for several weeks, came to similar conclusions. As a result, stem cells grew and multiplied in the gut of rodents, which increased the chances of developing cancer.”The systematic use of trans fats, chips, popcorn, animal fats can really lead to & nbsp; high cholesterol, hypertension, obesity, cause irreversible cell mutations and, as a consequence, lead to & nbsp; malignant processes in the body”, & nbsp; & mdash; confirms oncologist Natalya Sukortseva. Main & nbsp; & mdash; According to French and & nbsp; Brazilian scientists, cancer is caused not by & nbsp; certain foods, but & nbsp; the way they are prepared.The cause of oncology is often the so-called ultra-processed food & nbsp; & mdash; baked goods and & nbsp; snacks, sodas, cornflakes with & nbsp; sugar, convenience foods and & nbsp; reconstituted meat products. Such food is high in sugar, fat and & nbsp; salt, but is poor in vitamins and & nbsp; fiber. Researchers analyzed data from more than one hundred thousand people and & nbsp; found that an increase in the consumption of highly processed foods by & nbsp; ten percent leads to an & nbsp; increased risk of developing cancer by & nbsp; ; 12 percent.In particular, for breast cancer, this figure is 11 percent. However, experts emphasize that the mechanisms of occurrence of malignant tumors are not fully understood. Oncological diseases, as a rule, are the result of the coincidence of several factors & nbsp; & mdash; genetic mutations, poor ecology, malnutrition and & nbsp; lifestyle. “Of course, one cannot blame this or & nbsp; another product or & nbsp; food additive for the & nbsp; occurrence and & nbsp; development of oncological diseases, the oncological process is very complicated, but & nbsp; our nutrition can often become a trigger for the formation tumors.Meals should be complete, varied, but & nbsp; moderate. It is necessary for & nbsp; normal metabolism and & nbsp; replenishment of the body with nutrients. You also need to & nbsp; lead a healthy lifestyle and & nbsp; give up bad habits. And most importantly, do not & nbsp; eat products with & nbsp; long or & nbsp; expired “, Natalia Sukortseva advises.

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Sechenov First Moscow State Medical University, Russia

MOSCOW, Dec 1 – RIA Novosti, Alfiya Enikeeva. According to the World Health Organization, every sixth human dies of cancer. In 2018 alone, cancer claimed 9.6 million lives. In about a third of cases, cancer has developed due to malnutrition, experts say. What products should be treated with caution – in the material of RIA Novosti.

Sweet death

March 1, 2017, 07:00Excessive consumption of refined sugar can lead to chronic diseases of the endocrine, cardiovascular systems, and also cause obesity. Sugar substitutes, artificial colors and flavors, drinks and products containing them are highly toxic. Penetrating through the mucous membranes of the larynx and esophagus, they are able to trigger malignant cell growth, and not only cause obesity. Abuse of harmful products can lead to cancer of the throat, esophagus and stomach and other organs and systems, “Natalya Sukortseva, oncologist, head of the oncological surgical department of combined treatment methods of the Clinic of Cluster Oncology, UKB 1, Sechenov University, told RIA Novosti.

Sugar is also dangerous because it contributes to the rapid growth of malignant neoplasms, Belgian scientists say. Cancer cells multiply due to very rapid glycolysis (this is the name of the process of breaking down glucose without the participation of oxygen). Its rate in tumor cells can be two hundred times higher than in normal tissues. A byproduct of high-speed glycolysis, fructose 1,6-bisphosphate, is able to activate specific proteins produced by the RAS genes. They, in turn, induce even greater growth of the malignant tumor.The result is a vicious “sugar” circle. According to a study by an international team of scientists, excessive consumption of sugar can cause cancer of the rectum, breast and bladder, but may protect against glioma, one of the most common types of cancer of the brain or spinal cord. After analyzing the data of about a million people, biologists found that a low concentration of sugar in blood and brain tissues is statistically associated with a high probability of developing a malignant tumor of the nervous tissue. February 1, 2018, 22:00 sausage

January 4, 2018, 15:32According to the IARC expert opinion, their regular use can lead to the development of colorectal cancer – even 50 grams of processed meat per day increases the chances of contracting cancer by 18 percent.

“Semi-finished products, sausages, smoked meats, ham contain preservatives hazardous to health, a lot of salt and various chemicals. Therefore, if you regularly eat such food for breakfast, lunch and dinner, then it is quite possible to earn colon cancer,” explained Natalya Sukortseva . ..

In addition, a love of sausages and wieners can lead to the development of breast cancer, according to scientists from the University of Glasgow (UK). Researchers analyzed the diet of more than 270 thousand European women and the incidence of cancer. It turned out that one sausage a week increases the risk of cancer by 15 percent. It is also harmful to eat a lot of red meat. Instead, scientists advise eating poultry or fish.

Fatty, tasty, unhealthy

March 3, 2016, 11:09 a.m. Science Scientists have understood why fatty foods accelerate the development of rectal cancer Fatty foods accelerate the development of rectal cancer and a number of other tumors for the reason that fat promotes the growth and division of intestinal stem cells. some of which subsequently form cancerous tumors.

Foods with a high fat content promote the appearance of aggressive malignant tumors and increase their growth rate by almost a hundred times, experiments on genetically modified mice have shown.

American scientists have disabled the gene encoding the Lpcat3 protein in rodents, which controls the synthesis of phospholipids in cell membranes. As a result, the level of cholesterol in the body of the mice increased. This led to the rapid division of stem cells in the intestinal tissues and caused the growth of malignant tumors in laboratory animals.

Researchers from the Massachusetts Institute of Technology (USA), who fed mice with fatty foods for several weeks, came to similar conclusions. As a result, stem cells grow and multiply in the gut of the rodents, which increases the chances of developing cancer.

“The systematic use of trans fats, chips, popcorn, animal fats can really lead to high cholesterol levels, hypertension, obesity, cause irreversible cell mutations and, as a result, lead to malignant processes in the body,” confirms oncologist Natalya Sukortseva.

The main thing is to cook correctly

February 8, 2018, 11:32 am Oncology is often caused by the so-called ultra-processed food – baked goods and snacks, carbonated drinks, cornflakes with sugar, semi-finished products and reconstituted meat products. These foods are high in sugar, fat and salt, but poor in vitamins and fiber.

Researchers analyzed data from more than one hundred thousand people and found that an increase in the consumption of highly processed foods by ten percent leads to an increase in the risk of developing cancer by 12 percent. In particular, for breast cancer, the figure is 11 percent.

However, experts emphasize that the mechanisms of occurrence of malignant tumors are not fully understood.Oncological diseases, as a rule, are the result of the coincidence of several factors – genetic mutations, poor ecology, unhealthy diet and lifestyle.

“Of course, one cannot blame one or another product or food supplement for the occurrence and development of oncological diseases, the oncological process is very complicated, but our diet can often become a trigger for the formation of a tumor. Nutrition should be complete, varied, but moderate. This is necessary for normal metabolism and replenishment of the body with nutrients. You also need to lead a healthy lifestyle and give up bad habits. And most importantly, do not eat foods with a long or expired shelf life, “Natalya Sukortseva advises.

Cancer prevention: Nutritional habits

Nutrition plays an important role in the etiology of malignant tumors. It is known that morbidity and mortality from malignant tumors varies considerably in different geographic regions. For example, the incidence of stomach cancer is very high in Japan, Korea, China and low in North America.At the same time, the incidence of malignant tumors of the colon, breast, and prostate is low in Southeast Asia and high in North America and Western Europe.

Studies of migrants from Southeast Asian countries to the United States have shown that in the first generation, the incidence of stomach cancer among Japanese and Chinese people living in the United States has decreased and the incidence of colon cancer has increased.

Studies of migrants have suggested that geographic variability in cancer incidence is due to environmental and lifestyle factors rather than population genetic characteristics.Therefore, a hypothesis was formulated about the role of nutrition in. etiology of malignant tumors. Observations of some religious groups, in particular Seventh-day Adventists, who follow a special diet that do not include meat products, have shown that they have significantly lower incidence of colon, breast, uterine and prostate cancer than the rest of the population. living next to them.

The relationship between dietary habits and the incidence of malignant tumors was first shown in correlation studies.Per capita consumption of fats (especially animals), meat and milk and calorie intake were found to be positively correlated with the incidence of colon, breast, uterine and prostate cancer.

Experimental studies have shown that restricting caloric intake as well as animal saturated fat inhibits the carcinogenesis process induced by chemical carcinogens. In some experimental studies, a decrease in fat intake without a corresponding decrease in calorie intake also led to a decrease in the number of induced tumors and a lengthening of the latency period of their development, i.e.e. inhibiting the process of carcinogenesis. Inhibition of the carcinogenesis process induced by chemical carcinogens as a result of restriction of energy and animal fat intake has been observed for malignant tumors of the breast and colon, as well as lung, skin and some non-epithelial tumors. It should be noted that, both experimentally and in epidemiological studies, it is very difficult to completely distinguish the effect of calorie intake from fat intake, i.e.This is because animal fat is the most energy-intensive food component and the main source of calories.

The mechanism of tumor growth inhibition associated with restriction of calorie intake can be explained by a decrease in cell proliferation and stimulation of apoptosis, increased DNA repair, a decrease in the formation of free radicals and, accordingly, damage to cells by them, a change in the hormonal profile, in particular, a decrease in the level of both general and free estradiol and testosterone.

Height (growth rate), weight, and level of physical activity are markers of energy intake in childhood and adulthood. In women, the age of onset of menstruation is also a very important marker of calorie intake during childhood. Epidemiological studies have shown that all of these characteristics affect the risk of cancer.

The mechanism of the carcinogenic effect of fats is associated with their influence on the synthesis and metabolism of steroid sex hormones such as estradiol and testosterone.Fatty acids, especially saturated ones, inhibit the binding of estradiol to blood plasma proteins, which is the reason for the high concentration of free estradiol circulating in the blood. Reducing fat intake has been shown to lead to lower levels of estrone and estradiol in women of childbearing age. In menopausal women, a decrease in fat intake from 40 to 20% led to a pronounced (by 17%) decrease in the plasma concentration of total estradiol. Fat intake also affects the concentration of the male sex hormone testosterone.It has been shown that the concentration of testosterone in the blood significantly correlates with the consumption of fats. For example, the concentration of testosterone in the blood is significantly higher in African Americans than in Africans living in Africa. The latter also have significantly lower fat consumption. At the same time, the incidence of prostate cancer is significantly higher in African Americans. A study of the hormonal profile of prostate cancer patients and control groups in countries with low and high incidence of prostate cancer in Japan and the Netherlands showed that both fat intake and testosterone concentration in the blood were significantly higher in the Dutch.

The mechanism of action of fats on the process of carcinogenesis in the colon is associated with their effect on the metabolism of the intestinal flora and the concentration of secondary fatty acids, which contribute to carcinogenesis in laboratory animals. In addition, fats stimulate the formation of fecapentans, substances with mutagenic effects in the colon, and most likely play an important role in the process of carcinogenesis in this organ. As a result of the processing of fats in the intestine, fecal sterols are formed, some of which play a key role in the proliferation of the colon epithelium.It has been shown that people with a high consumption of fats in feces have a high concentration of secondary fatty acids, fecapentans, a more pronounced metabolism of the intestinal flora, as well as the process of converting lipids into mutagenic fecal sterols.

The association between animal fat consumption and the risk of colon, breast, and prostate cancer has been shown in many analytical epidemiological studies. In most of the works published before the mid-80s. XX century, it was revealed that the risk of colon, breast, prostate cancer is increased in people with a high consumption of animal fats and meat.However, analytical epidemiological studies of subsequent years, which used more accurate methods for estimating the consumption of fat and other nutrients and improved methods of statistical analysis, questioned this statement.

A cohort study of American nurses, which included 90,000 participants, did not find an increase in the risk of breast cancer in a group of women with a high intake of fat in general, and in particular, saturated fatty acids and cholesterol.However, a meta-analysis of 12 case-control studies showed a small but statistically significant increase in breast cancer risk associated with high rates of fat intake in general and saturated fat in particular. Thus, the role of fat consumption in the etiology of breast cancer remains unclear.

It has been hypothesized that studies that have found such an association likely failed to separate the effect of energy intake from the effect of fat intake.As mentioned above, fat is the most energy-intensive nutrient and most of the calories consumed by a person (over 40%), especially in developed countries, is represented by fats.

As for the epidemiological studies of colon cancer, most of them show a relationship between the consumption of fat, especially saturated, and meat with the risk of cancer of this organ. For example, the aforementioned cohort study of American nurses found a statistically significant increase in the risk of colon cancer in women with a high intake of animal fats, beef, pork, lamb, and sausages.This and another American cohort study of health care workers showed that the risk of cancer and colon adenomatous polyps depends on the ratio of meat consumption to poultry and fish consumption, i.e. the higher the consumption of meat compared to the consumption of poultry and fish, the higher the risk of cancer of this organ.

Carbohydrates, along with fats, are an important source of calories. In developing countries, carbohydrates account for 70% or more of energy consumed. In developed countries, the proportion of carbohydrates in the diet is decreasing due to an increase in fat consumption.In food, carbohydrates are presented in the form of starch, sugars and other polysaccharides, most of which are so-called fiber. The main source of starch is cereals (bread), cereals, potatoes, peas, beans. Fiber is an essential component of plant foods, vegetables, fruits and unrefined (unrefined) cereals.

A hypothesis about the protective role of fiber was formulated by the British physician Burkitt based on observations in Africa, where the incidence of colon cancer is low and the consumption of foods high in fiber is high.It is assumed that people who consume a lot of fiber have an increased volume of stool, which leads to a decrease in the concentration of carcinogenic substances in the colon.

Clinical metabolic studies have shown that the addition of 10–13 g of cellulose or grain fiber (wheat bran) to the daily diet significantly reduces the concentration of secondary bile acids in the feces, their metabolic and mutagenic activity.

Most analytical epidemiological studies have supported the hypothesis of a protective effect of fiber.A meta-analysis of 16 case-control studies confirmed an inverse association between dietary fiber and fiber-rich foods and the risk of colon cancer. A prospective study of American health care workers, which followed about 10,000 men, found that eating fiber, which is sourced from fruits and vegetables, as well as grains and cereals, reduced the risk of adenomatous polyps and colon cancer. However, in a cohort study of American nurses, as in a number of other epidemiological studies, it was shown that only fiber in vegetables and fruits has a protective effect against colon cancer.And this protective effect can also result from the action of vitamins, indoles, proteases and other components of fruits and vegetables.

The protective effect of consumption of vegetables and fruits in the development of malignant tumors in humans has been proven for cancers of the oral cavity and pharynx, esophagus, stomach, colon and rectum, and lung. The volume of epidemiological scientific evidence is weaker for cancers of the larynx, pancreas, breast, and bladder. However, consuming vegetables and fruits is likely to reduce the risk of developing these tumors.In some epidemiological studies, a decrease in RR due to the consumption of vegetables and fruits has also been noted for tumors of the cervix, endometrium, kidney and prostate. In addition, the consumption of vegetables and fruits has been shown to reduce the risk of all forms of malignant tumors in general. One cohort study found that men who ate a lot of green and yellow vegetables had a 0.3 risk of dying from all forms of cancer. Onions and garlic have a pronounced protective effect. In a study we conducted in Moscow, it was shown that consuming garlic significantly reduces the risk of stomach cancer.The anticarcinogenic effect of garlic can be explained by its bactericidal properties, in particular against Helicobacter pylori, infection with which is a known risk factor for developing stomach cancer.

Vegetables and fruits contain active substances that inhibit the development of tumors in an experiment on laboratory animals. These primarily include vitamins C, E, beta-carotene, selenium, which have antioxidant properties, vitamin A, folic acid, as well as phytoestrogens (isoflavinols), flavonoids such as quercitin, indoles, etc.d.

Vitamin A plays a central role in cell differentiation, which has led to the hypothesis that vitamin A may be an inhibitor of carcinogenesis. This hypothesis has been confirmed in experimental studies. The precursors of vitamin A are carotenoids, which in the experiment turned out to be inhibitors of carcinogenesis, especially in a model of skin cancer. Analytical epidemiological studies have confirmed the protective effect of carotenoids and, to a lesser extent, vitamin A.It should be emphasized that the source of vitamin A is animal products, while carotenoids enter the human body exclusively with plant products.

Case-control and cohort studies that assessed the intake of vitamin A and carotenoids using a questionnaire and blood tests for these vitamins found that high dietary intake of carotenoids and high blood concentrations reduces the risk of lung cancer.Carotenoid intake reduces the risk of cancer of the larynx, esophagus, stomach, breast, bladder, and cervix.

Vitamin C is an antioxidant and, in addition, inhibits the endogenous formation of nitrosoamines in the stomach from amines and nitrites ingested with food. In a number of case-control studies, the protective effect of vitamin C consumption has been noted. It has been shown that people who consume a lot of vitamin C with food have a reduced risk of developing cancer of the oral cavity, larynx, esophagus, stomach and cervix.As with other vitamins, it is not entirely clear whether vitamin C or other components of fruits and vegetables that contain vitamin C are protective. Vitamin E is also a powerful antioxidant. Experimental studies have shown that vitamin E inhibits the process of carcinogenesis. Epidemiological studies that have examined the effects of dietary intake of vitamin E and its concentration in the blood are inconsistent. It should be noted, however, that studies investigating the relationship between vitamin E levels in the blood have shown an inverse relationship between vitamin E levels and the risk of malignant tumors, and especially those that are not causally related to smoking.

The carcinogenesis inhibiting effect of selenium has been shown in many experimental studies. In addition, epidemiological studies have noted an inverse correlation between the level of selenium intake and the incidence of malignant tumors. The correlation is especially pronounced for colon and breast cancers. Analytical epidemiological studies are less convincing. Several prospective studies that examined the concentration of selenium in the blood showed a decrease in the risk of malignant tumors of the breast and lung with an increase in the concentration of selenium in the blood.As for other forms of cancer, epidemiological studies can neither confirm nor deny the possibility of the protective effect of selenium on their development.

Salted, smoked and canned foods may contain various carcinogenic substances. There is reason to believe that nitrosamines, as well as their precursors (nitrates, nitrites) in food, are associated with an increased risk of esophageal and gastric cancer. An increased risk of stomach cancer is observed among people who consume a lot of salt.

Although our current knowledge is insufficient to pinpoint all the nutritional components that promote cancer or reduce the risk of cancer, there is no doubt that an increase in consumption of vegetables, herbs and fruits and a decrease in fat intake ( especially animal) will lead to a decrease in the incidence of malignant tumors.

90,000 Medical nutrition for patients with cancer

Nausea, vomiting and diarrhea are some of the most common complications of chemotherapy.Up to 70% of patients receiving chemoradiotherapy experience significant weight loss.

Although many patients do not experience complications during the first courses of chemoradiation, the risk of these complications increases in the future. Eating disorders can cause changes in the therapy regimen, affect the results of treatment, and reduce the quality of life. It is very important to use therapeutic nutrition for patients who are planning to undergo long-term courses of treatment. It is necessary to start supportive nutritional therapy without waiting for mucositis, enteritis or other complications, but in advance, 7-10 days before the start of the course of chemoradiation therapy.Timely initiation can help avoid severe complications and provide treatment for a more radical program, mainly by reducing the incidence of gastrointestinal complications.

Side effects of radiation therapy primarily depend on which area of ​​the body it is directed to. All patients undergoing radiation therapy may experience weakness and loss of appetite.

The most pronounced symptoms occur with radiation therapy for tumors of the head and neck.If the area of ​​the mouth and pharynx enters the irradiation zone, patients may experience serious damage to the mucous membranes, changes in taste and smell, and aversion to food. With radiation damage to the esophagus, swallowing disorders, nausea, vomiting occur, which also significantly limit the possibility of normal nutrition. With irradiation of the abdomen and pelvis, there is a risk of damage to the intestines, which leads to the development of diarrhea, indigestion, nausea, and vomiting.

Side effects of chemotherapy are determined by the type of drugs used and the specific treatment regimen. Nausea, vomiting, food aversion and diarrhea are most common. Stomatitis, mucositis, and esophagitis resulting from treatment are especially painful for patients.

Another dangerous common complication for chemotherapy and radiation therapy is suppression of immunity (neutropenia, leukopenia). In the presence of such complications, it is extremely important to monitor the preparation, processing and shelf life of the products used, since the slightest bacterial contamination threatens the development of severe infections.That is why it is strictly recommended to take products manufactured in sterile or processed in special conditions packaging.

Treatment of nutritional complications of chemotherapy and radiation therapy consists of three main components:

• fight against nausea, vomiting, loss of appetite,
• special diet,
• Consuming easily digestible nutrients, primarily proteins and energy-rich fats and carbohydrates.

90 250 90 000 Ovarian tumors.Clinical manifestations, diagnosis, Risk factors, treatment

Ovarian tumors (benign and malignant) can occur at any age, but more often appear in 40-50 years. In terms of frequency, they rank second among tumors of the female genital organs, with a significant prevalence of benign forms (75-80%).

The problem of recognition of malignant ovarian tumors is one of the most urgent. Its relevance is due to the undoubted increase in morbidity and mortality from this pathology, noted over the past decades in many countries of the world.The majority (75-87%) of patients with malignant ovarian tumors are admitted for treatment in advanced stages of the disease, which affects the low 5-year survival rate not exceeding 10%. for medical help.

Frequent symptoms of ovarian tumors (benign and malignant) are painful sensations, referred to by patients as “stretching” in the lower abdomen, which is associated with the pressure of the tumor on adjacent organs.Persistent or recurrent abdominal pains occur without a specific localization (in the epigastric region or hypochondrium). Often they can stop for more or less long periods of time or appear as sudden sharp pains as a result of torsion of the leg or rupture of its capsule. In malignant tumors, the most noticeable symptoms, but not early ones, are: deterioration in general condition, weakness and fatigue.

In most cases, even with advanced forms, when the process in the form of small disseminates spreads over all the sheets of the peritoneum, liver, spleen, etc.organs of the clinic, has an erased character. In some cases, it is expressed in “discomfort” from the gastrointestinal tract in the form of loss of appetite, weakness, nausea, and an increase in the volume of the abdomen. The clinical manifestations in the common forms of the disease are more pronounced than in the early ones. In such cases, there is bloating of the intestine, especially in the upper section, and satiety from small portions of food, which is due to the large volume of the tumor and the appearance of large metastases in the omentum, which makes it difficult to pass gas.As the tumor grows or ascites grows (the appearance of free fluid in the abdominal cavity), the volume of the abdomen increases, shortness of breath develops, and a feeling of fullness arises. The progression of the disease is rarely accompanied by an increase in body temperature.

With advanced forms of ovarian cancer, the menstrual cycle is disrupted, dysfunctional uterine bleeding occurs, the amount of urine excreted decreases, and constipation occurs.

The diagnosis of ovarian tumors is based on the detection by the doctor of various sizes and forms of tumor formation in the small pelvis, painless, moderately and limitedly displaceable, with a bumpy or smooth surface, having a dense or tight-elastic consistency.Often in the morning, when the bladder is filled, the patient herself probes the tumor over the bosom.

The asymptomatic development of a tumor process in the ovaries in the early stages of the disease forces clinicians to develop more advanced methods of their recognition and to single out a group of patients at increased risk, i.e., persons with risk factors. Judgments about the significance of anamnestic data in patients with ovarian cancer are heterogeneous, but, nevertheless, summarizing them, one can find indications of signs preceding the development of a tumor in the form of endocrine hormonal disorders:

• later onset of menstruation;
• infertility;
• diabetes mellitus;
• early or late menopause;

90,244 obesity;

• fibroids;
• adenomyosis, etc.

Of particular importance in malignant neoplasms are information about a history of chronic inflammation of the uterine appendages or surgery for a benign ovarian tumor. It is known that with unilateral removal of a benign ovarian tumor, it is very likely that a tumor will appear in another left ovary, but at the same time it is already malignant. Information about tumor diseases in the family is also important. All of these details should be known to women of all ages seeking to help doctors recognize early ovarian cancer.

Fundamental works devoted to the identification of hereditary forms of ovarian cancer have shown that approximately 18% of cancer patients have family history of relatives affected by ovarian cancer, breast cancer, and colon cancer.

The available factors and indirect evidence are sufficient to suggest that this disease occurs in conditions of metabolic and hormonal changes in the body, i.e. in the presence of risk factors. The concept of “risk factors” was introduced into clinical practice in order to search for changes in “practically healthy” people that predispose to the onset of cancer.Risk groups are population groups in which, due to the influence of various reasons (age, occupational, genetic, household, behavioral and metabolic endocrine), the risk of the onset and development of tumors is higher than for other population groups where the influence of these factors is absent or small. In the presence of these factors, changes are observed in the body that are characteristic of precancerous diseases and cancer.

It should be emphasized that the risk of genital cancer increases when the examined patients have a combination of 2 and 3 signs.Therefore, every woman, when she notes the presence of risk factors, should appear for preventive examinations by a midwife or doctor at least 2 times a year, which allows detecting ovarian cancer at an early stage of the disease.

To clarify the diagnosis, the patient is examined using ultrasound scanning of the pelvis. The advantage of the ultrasound method in the diagnosis of ovarian tumors is its high information content, simplicity, speed, harmlessness, painlessness, the possibility of repeated carrying out and objective documentation.

Of great importance in the diagnosis of malignant ovarian tumors is the search for tumor markers – specific biological substances produced by the tumor, which can be determined by biochemical or immunological methods. With regard to ovarian cancer, the most studied tumor is the associated antigen CA-125. The content of CA-125 above 35 U / ml is determined in almost 80% of patients with ovarian cancer.

Surgical is the only viable treatment for benign ovarian tumors.Since it is not possible to identify the benign or malignant nature of the tumor without a morphological study, a rule has been developed according to which each diagnosed ovarian tumor, regardless of whether it is large or small, is subject to surgical treatment. In young women, with a benign nature of ovarian neoplasm, a rational volume of intervention is either ovarian resection (removal of altered tissue), or removal of only the tumor, or removal of the uterine appendages on one side.

In menopausal women, removal of not only the tumor, but also the unaffected uterine appendages on the other side is shown.

Treatment of malignant ovarian tumors is carried out according to an individual plan, taking into account the results of a comprehensive study, which gives a complete picture of the extent of the tumor process and its morphological structure.

It is advisable to start treatment from the surgical stage in the presence of large tumor formations in the small pelvis.In those patients with ovarian cancer, in whom, due to the prevalence of the tumor process or a sharp weakening, a radical amount of intervention seems impossible, then chemotherapy is used at the first stage, and the operation is undertaken when, under the influence of chemotherapy, the tumor has decreased in size, has become displaceable and the general condition of the patient has improved.

Among the measures for the prevention of ovarian cancer, a healthy lifestyle is assumed.

Given the fact of metabolic disorders, including obesity in the development of malignant ovarian tumors, women of all ages should not allow obesity and follow a diet that ensures optimal use of beta-carotenes, which include foods such as parsley, dill, spinach, green onions, tomatoes, garlic, etc.

Vitamins, in particular A, B, C, contained in fish oil, fish, liver, nuts, cabbage, black currants, etc. also have antitumor activity.

Since ovarian cancer often develops in women with infertility, the use of vitamin E, contained in vegetable oils, in wheat germ, in nuts, is indicated for its prevention.

As a reference, we inform you that the most famous antitumor effect is also possessed by a microelement – selenium, the highest content of which is found in seaweed, seaweed, in the bran of cereal plants, brewer’s yeast, etc.products.

The essence of dietary cancer prevention lies in moderation of food intake, in limiting, up to exclusion, pickles, canned food, marinades, smoked meats, salt, animal fat and sugar in finished food products.

It should be remembered that decreased physical activity and physical inactivity contribute to the disruption of blood vessels, muscle elasticity, the growth of excess body weight, which leads to obesity and cancer.

Move often, play sports, avoid abortion, have a normal sex life.Refrain from changing sexual partners and smoking.

Authors:

Professor E.E. Vishnevskaya

cand. honey. sciences O.P. Matylevich

treatment, diagnostics, surgery to remove adrenal adenoma

Adrenal tumors are often diagnosed by chance. Then she is called “incidentaloma” (from the word incidental – casual). According to world statistics, one in ten people on Earth have insidentaloms.There are many types of insidentals, depending on their structure. However, it is possible to clarify what kind of tumor it is – actually adenoma, pheochromocytoma, lipoma, cyst, hemangioma, teratoma, neurofibroma, sarcoma, adrenal cancer or something else is possible only with a detailed full examination. It is advisable to carry out such an examination in an endocrinological center, which has the appropriate equipment and experienced doctors.

If the examination of the signs of malignancy of the tumor is not found, then it is legitimate to call such a tumor an adrenal adenoma.Hormonally, adenomas can be active (they are less common) and inactive (98% of them). Some of them produce cortisol – they are called corticosteromas, others produce aldosterone – these are aldosteromes; and some produce male sex hormones androgens – these are androsteromas.

Symptoms of adenoma

There is a fairly large spread of adrenal tumors in the human population. And often, their accidental detection indicates that this disease rarely manifests itself with certain symptoms.As a rule, the size of adrenal tumors is not large, and in order to influence the surrounding tissues, squeezing them, the size of the tumor must exceed 10 cm, which is extremely rare. In addition, only hormonally active adenomas have a variety of symptoms, and there are only 2% of them. While hormonally inactive – they do not manifest themselves clinically and are unexpectedly detected on ultrasound or CT – studies.

Let us examine the symptoms of hormone-active tumors. Depending on which hormone the tumor produces, the corresponding symptoms appear.

Clinic with corticosteroids

This type of adenoma is more common in women 20-40 years old. A significant production of cortisol by the tumor (hypercortisolism) leads to the development of “Itsenko-Cushing’s syndrome” in the patient. Hypercortisolism in most patients is manifested by obesity, which has specific features: fat is deposited on the face, neck, chest. Characteristically a rounded face, the skin becomes thinner, and the disappearance of subcutaneous fat is observed on the back of the hand. The muscles of the buttocks, shoulders, legs become weak, as the muscles atrophy.It is difficult for a person to move, get up. The appearance of hernias is possible, since atrophy of the muscles of the abdominal wall also occurs; “frog belly” is noted. On the skin of the abdomen, mammary glands, thighs and shoulders, there are characteristic stretch marks of a purplish red color, which are called “striae”. Osteoporosis is formed due to the fact that bones lose mineral salts from their structure, fractures and a decrease in the height of the vertebral bodies are observed. There are hip fractures. Steroidal diabetes mellitus occurs in one in 10 patients.Such diabetes is usually compensated for by diet and antidiabetic pills. In women, excess hair growth appears, the menstrual cycle is disrupted. The psyche of patients suffers – depressive reactions occur.

Symptoms of aldosteroma

Since this tumor produces aldosterone, a condition develops that is called “primary hyperaldosteronism”, another name is “Conn’s syndrome”.

Aldosteroma is a benign tumor, no more than 3 cm in size.The most typical symptom for this condition is high blood pressure. The pathogenetic mechanism is associated with the fact that an excess of aldosterone, affecting the cells of the distal tubules of the kidneys, enhances the reabsorption of sodium ions, thus increasing its amount in the patient’s body. Excess sodium leads to fluid retention, and the consequence is an increase in the volume of circulating blood and, accordingly, in blood pressure. Sodium-potassium metabolism is finely regulated at the level of the renal tubules: aldosterone, activating the reabsorption of sodium in the kidneys, in exchange for this increases the excretion of potassium in the urine.Thus, another important symptom of this hormone-active tumor is hypokalemia (a decrease in potassium in the blood). This leads to weakness, impaired performance, cramps and muscle pain.

If a tumor produces androsterone, a male sex hormone, it is called an androsteroma. In men, this tumor is detected late, since its symptoms are not noticeable. In women, symptoms of virilization are observed – the voice coarsens, hair on the face and chin begins to grow, muscle mass grows; the mammary glands, on the contrary, decrease, but the clitoris increases.The cycle of menstruation is disrupted.

Algorithm for the diagnosis of adrenal adenoma

• If an adrenal tumor is found, the first question to be answered is “is it benign adenoma or adrenocortical cancer?”

• The second question: “Is there hormonal activity or not?”

This is where a CT scanner comes to the rescue.It is important to use a multislice tomograph that makes at least 64 slices. The study of the adrenal glands is performed with intravenous contrast enhancement. As a result of the study, it is necessary to obtain the size of the tumor, to determine its density. Non-malignant adenoma has a low density, the contours are clearly traced, the size is not large – more often about 3 cm, sometimes larger. At the second stage, after the injection of a contrast agent, the tumor is examined in the venous or arterial phase to determine the rate of accumulation and washout of contrast, which occurs quickly and completely in a benign tumor.

• Sometimes, MRI can be used to clarify diagnostic questions, but less often than CT.

• If the task is to find out whether the adrenal gland is affected by a metastasis of a tumor that has developed from another organ, a biopsy of the adrenal gland is done. However, the method is traumatic and rarely used.

• L Aboriginal studies are of great diagnostic value for hormonally active tumors.The level of cortisol, as well as adreno-corticotropic hormone (ACTH) in the blood fluctuates during the day, it cannot be used to unambiguously determine how the adrenal glands work. But the determination of cortisol in daily urine gives an idea of ​​their basic function.

• Small dexamethasone test reveals even indistinct manifestations of hormonal disorders in Itsenko-Cushing’s syndrome. The test is carried out within one day. First, the level of cortisol in the patient’s blood is determined.At 24 hours on the same day, 1 mg of dexamethasone is taken. The next morning, cortisol in the blood is determined again. A normal indicator (positive test) is a decrease in cortisol by 2 or more times. If this does not happen (negative test), then the tumor produces cortisol on its own, and this process is not controlled by the body.

• large dexamethasone test is of great importance in the differential diagnosis between the syndrome and Itsenko-Cushing’s disease.It is carried out according to the same scheme as the small one, however, the dose of dexamethasone is not 1 mg, but 8 mg. In the presence of a cortisol-producing adrenal tumor, the test will be negative, and in the case of Itsenko-Cushing’s disease (pituitary adenoma), cortisol will decrease by 2 or more times.

• Patients with adrenal adenoma should also test chromogranin A, calcitonin, parathyroid hormone, blood ions, adreno-corticotropic hormone, aldosterone and renin in the blood .

How to treat adrenal adenoma?

A non-hormonal and benign small adenoma should be observed at least once a year. The doctor controls the size of the tumor according to CT scan without contrast enhancement, cortisol and some other blood parameters. If there is no dynamics, then no treatment is needed. This type of adenoma occurs most often.

Indications for adenoma removal

1. 1.The tumor is more than 4 cm in size.

2. 2. Established hormonal activity of the tumor.

Removal of adrenal tumors is currently possible with gentle and less traumatic methods. This approach is possible only in a specialized institution where such operations are carried out on a stream. The modern understanding of surgery indicates that the surgeon masterfully masters the technology of performing a certain type of operation in the case when he performs at least 100 operations per year of this profile.It is experience that ensures the high quality of the surgeon’s work.

A few years ago, the open method of surgery on the adrenal glands was the only method of surgical treatment and is now common for many surgeons. In this case, a large incision of 20-30 cm is made, the muscles of the abdominal wall, chest wall and diaphragm are intersected. High trauma, long rehabilitation period, a number of complications are typical for such access to the adrenal gland.

Later, laparoscopic method of operations on the adrenal glands appeared, which is less traumatic.Access is through the abdominal wall through 2-3 punctures. With this method, the peritoneum is injured, which can lead to the development of adhesions in it. In addition, carbon dioxide is injected to create space for access to the adrenal gland through the abdominal cavity. As a result, the volume of the chest cavity can decrease due to the raising of the diaphragm and reduce the vital capacity of the lungs, which is difficult for patients with cardiovascular and pulmonary pathology. The laparoscopic method is contraindicated in those who have had abdominal surgery and there is a risk of adhesions.

Our Clinic uses the third of the existing approaches – lumbar . It should be noted that the kidneys with the adrenal glands are located behind the peritoneum, so the approach to them from the back is more convenient and less traumatic. This approach is called retroperitoneoscopic – retroperitoneal. During this operation, the peritoneum is not involved, there is practically no risk of damage to organs in the abdominal cavity, the person lies comfortably on his stomach, which eliminates problems with the spinal column after the operation.Often, one incision of about 2 cm is sufficient; the operated area is visualized on a video monitor. Patients tolerate this operation well and can be discharged 2 days after the operation.

The functional subdivision of our clinic – the North-West Endocrinology Center in terms of the number of operations on the adrenal glands has been ranked first in Russia for several years. More than 200 interventions are performed per year, usually with a lumbar approach. The hospital stay does not exceed 3-4 days.

Most surgical interventions on the adrenal glands for residents of Russia are carried out according to federal quotas (free of charge for the patient). For those who wish and residents of other countries, operations can be performed for a fee.

In order to be treated at the Clinic, you need to get advice from our surgeon – the endocrine department. If there is a referral from the polyclinic at the place of residence, the consultation is free of charge (according to the compulsory medical insurance). The patient needs to come for a consultation with all available medical examinations.

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Important

If an in-depth examination is required, the doctor at the consultation can offer the patient hospitalization for 2-4 days to clarify the diagnosis and determine the indications for surgical treatment. In this case, the examination is carried out as part of the compulsory medical insurance (free of charge for the patient). Nonresident patients who have questions or for hospitalization can send a copy of their passport, compulsory medical insurance policy, SNILS, examination results to the address: [email protected] or 6762525 @ gosmed.ru

How does bowel cancer develop?

2019.09.27

Although it is possible for someone to develop colon and rectal cancer, it is most common in people over 50. Cancer is most common in developed, stable economies. This is the price paid for the rapid development of technology that, as the quality of life improves, makes people less mobile and obese. Bad eating habits (red meat, especially when cooking at high temperatures, excess animal fat in food, lack of food rich in plant fiber) also negatively affect the state of the intestines and contribute to its pathological processes.Although most people believe that their genetic code carries a risk of developing bowel cancer, only less than 10% of all cancers can be attributed to genetic abnormalities.

In fact, scientists believe cancer is more influencing our way of life:

Diets high in red and processed meat
obesity
smoking
Physical inactivity
Alcohol consumption

Bowel cancer usually starts out as a “polyp”.Polyps are small growths on the inner walls of the colon (colon and rectum). People usually don’t feel them. Polyps are often less than a centimeter long, but can grow up to several centimeters. Some people only grow one polyp, while others grow multiple polyps. Polyps are more common in older people. Polyps are caused by an excess of cells. The cells of the intestinal mucosa are constantly renewing, but any altered gene can cause the mucous cells to multiply even faster and without regrowth.Although most colon polyps do not become cancer, virtually all colon and rectal cancers begin with these tumors. Initially, they develop as benign structures, and then partially turn into malignant neoplasms.

Cancer can also develop from abnormal cells in the colon or rectum that cause certain inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis.

Most colon and rectal tumors are silent.They grow slowly and often cause no symptoms. Symptoms begin to appear as the disease progresses significantly.

What are the symptoms of colon and rectal cancer?

Colon cancer is insidious because it is virtually invisible in its early stages and can be accidentally discovered in the absence of symptoms or ignored symptoms, and should be screened for risk or unusual bowel disorders. Doctors can do a lot of research to help diagnose bowel cancer and polyps early.It is:

• Rectoscopy / sigmoidoscopy. This is an outpatient procedure used to examine the rectum and the very last part of the colon. Using a short, narrow surgical instrument with a light source. On examination, the patient lies sideways in a folded position. A specialist examines the inner wall of the lower colon. Only the rectum can be viewed with a rectoscope. The sigmoidoscope is slightly longer and you can see not only the rectum, but the rectum as well.If lesions of the intestinal mucosa are found, these instruments can be used to take a piece of tissue for examination.

• Colonoscopy – Similar to the procedure above using a long flexible instrument that allows you to view the entire colon. This procedure takes about 30-40 minutes. During a colonoscopy, the entire intestine should be completely empty. Before the procedure, it is necessary to cleanse the intestines with laxatives. The procedure is performed with the patient lying on their side.In the absence of analgesia, this procedure is somewhat inconvenient, but recently it has been performed under full anesthesia, so that the patient does not experience any unpleasant sensations. At Kilda Clinic, this procedure is performed on an outpatient basis and patients return home afterwards.

Computed tomography (CT) is a type of X-ray examination that includes many images of the chest, abdomen, or other areas of the body. The photographic images are sent to a computer, which gives an accurate picture of the location of the internal organs.It is recommended not to drink or eat for a few hours before the test. If the examination is carried out using a contrast agent (special dye), it is necessary to take a special liquid several hours before the examination to ensure the quality of the obtained X-ray images. Immediately before the test, a tube is inserted into the rectum through which a contrast agent is injected. It is not a pleasant procedure, but it ensures the quality of the X-rays. When the patient is comfortable lying on the CT table, the examination begins.The scanning procedure is not painful, but the patient needs about half an hour to be inactive for the required number of photos. You can return home immediately after the examination.

Bowel cancer symptoms:

The earliest sign of colon cancer may be bleeding. Often, tumors do not bleed very well, and signs of bleeding are only found on chemical analyzes of stool. This is called occult bleeding, which means it is not always visible to the naked eye.When tumors grow large, they can change the frequency of bowel movements or stool consistency and cause intestinal obstruction. As the process develops, symptoms develop:

Prolonged bowel movement (eg, constipation or diarrhea).
Blood on the stool is already visible to the naked eye
Abdominal pain, feeling of fullness in the intestines
Unexplained weight loss
anemia
Constant fatigue
What happens if an intestinal polyp is found?

Polyps, so the rule is removed and sent to the laboratory for microscopic analysis.