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Suggest treatment for lipoma on arm

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Oncologist
Practicing since : 2004
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Question
My husband has what we thought was a lipoma on his arm - he's 54. There's one on his foot too, but the concern right now is the arm. Has had x-rays and a MRI - MRI came back "inconclusive" so they have referred him to a specialist. What are the odds this is a lipoma and not a fibrosarcoma? If it's cancerous, depending on staging, can they simply remove it???
Posted Mon, 25 Aug 2014 in Cancer
 
 
Answered by Dr. Monish De 2 hours later
Brief Answer:
Biopsy

Detailed Answer:
Hi

Since your husband has a suspected lipoma in his arm i will recommend a biopsy from the area to rule out malignancy.
Most lipomas are treated by removing them surgically and cutting them out. Recurrences after removal are uncommon.
There's a very small chance that a lump resembling a lipoma may actually be a form of cancer called fibrosarcoma.
Staging will depend on whole body PET CT.
If the cancer is in stage 1 or 2 it may still be possible to surgically remove it.

Hope i have answered your query.

Regards
DR De
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for lipoma on arm 4 hours later
Thank you for the information! Two questions: how long does it take to get biopsy results and what percentage of lipomas turn out to be fibrosarcomas?
 
 
Answered by Dr. Monish De 5 minutes later
Brief Answer:
3 to 5 days

Detailed Answer:
Hi

Generally it takes around 3 to 5 days for biopsy results to come out.
Only 5 to 10 percentage of lipomas turn out to be fibrosarcomas.

Wishing your husband good health.

Regards
DR De
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for lipoma on arm 15 hours later
MRI says small solid mass not characteristic of lipoma, no other masses, the underlying osseous structures are normal and no abnormal neurovascular enhancement...calling it indeterminate lesion...could it be schwannoma or neurofibroma? Predominantly intermediate T1 and mildly heterogeneous T2 signal with heterogeneous enhancement.
 
 
Answered by Dr. Monish De 7 hours later
Brief Answer:
Schwannoma

Detailed Answer:
Hi


Schwannoma shows heterogeneous enhancement along with cystic and fatty degeneration, peripheral arachnoid cysts and peritumoural oedema.On T2 weighted images in MRI the signal intensity appeares significantly hyperintense and heterogeneous.

In neurofibroma a hyperintense rim and central area of low signal resulting in a target sign is seen with minimal or no contrast enhancement on MRI .T1 is hypointense and T2 is hyperintense.

MRI picture indicate more towards Schwannoma rather than neurofibroma but the confirmatory test is biopsy.

Regards
DR De
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for lipoma on arm 4 days later
My husband went to the orthopedic oncologist/surgeon today and the story I am hearing is the doctor seemed to act like the lesion was "no big deal" and didn't even send him for a biopsy. He even apparently said he could not have it removed...though in the end, my husband agreed to get it out soon.

I asked if it was a schwannoma and all I heard was the word "myxoid" which I know is a class of tumors, both benign and malignant. Then my husband mentioned something in passing about "on the rare chance it's bad, I might have to get some radiation"...question: could they be planning to biopsy this tumor once removed?

And are there myxoid tumors that can present as benign and then end up as not? Are you surprised there was no pre-op biopsy? Husband said the doctor referred to it as a "bump."

I think my husband tends to gloss over things. Thanks!
 
 
Answered by Dr. Monish De 6 hours later
Brief Answer:
biopsy and immunohistochemistry tests

Detailed Answer:
Hi

Your oncologist surgeon is planning to remove your husbands lump in his arm then perform a biospy after surgery on the removed histopathological specimen. That can also be done.

Superficial myxoid lesions in general are benign and deep ones are malignant.

For diagnosing a myxoid tumour a biopsy and immunohistochemistry tests are necessary from the surgically removed histopathological specimen.

Myxoid tumors are often seen having the presence of a myxoid stromal matrix with a gelatinous material.

Consult with your doctor regarding these features after biopsy results come out.

Regards
DR De
Above answer was peer-reviewed by
 
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