Should fatty tumors be removed?

By Peter H. Gott, M.D. Published: July 13, 2010

DEAR DR. GOTT: I am a 53-year-old female who is about 50 pounds overweight. I have saved, for years, the column you wrote on fatty tumors. I had a few of them, but my doctor said to leave them alone, even though they could be seen through my clothing. In the past two to three years, they have multiplied, and I know I probably have hundreds of them. I've had a few removed that are painful, and they were lipomas, as suspected. Some of the remaining ones are painful; some are not.

Should I continue to "let it go," or should I have more removed?

In your column, you said it could be associated with Gardner's syndrome. Should I look into that area? Would losing weight help, or would they just be more pronounced?

DEAR READER: Most peripheral nerve tumors are benign. There are a number of types, including lipomas, ganglion cysts, schwannomas, dumbbell tumors and neurofibromas.

Lipomas present as soft lumps under the skin, commonly appearing on the back, neck, arms or shoulders, caused by slow-growing fat cells. As a general rule, they do not cause pain, but because they can compress nerves, you should have periodic exams.

Ganglion cysts can occur almost anywhere but commonly form near the wrist or at the base of a finger. If there's no pain, you can ignore them. If there's pain, restricted use of a joint and paresthesias, surgical removal may be appropriate.

A schwannoma is common, slow-growing, benign and can appear anywhere on the body. Vestibular schwannomas occur near the cerebellum and brainstem. They can press on the nerves that control balance and affect hearing.

Dumbbell tumors are so called because of their appearance. They may occur in the spine or lower abdomen by the hip. They can become intertwined with the sciatic nerve. If surgery is necessary, it should be accomplished at an extremely reputable facility.

Neurofibromas are common in people diagnosed with neurofibromatosis. Most patients have mild symptoms, but related conditions, such as bone enlargement or deformity, scoliosis and tumors affecting the eye, can occur.

Colon polyps, multiple osteoma and soft-tissue tumors characterize Gardner's syndrome. The average age of diagnosis is 22. A common symptom, other than lipomas is dental anomalies, such as multiple impactions. Treatment depends on the location and appearance of the lesions. Surgical excision may be recommended.

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