Читать книгу Veterinary Surgical Oncology - Группа авторов - Страница 156

Lipomas are, together with adenomas and mast cell tumors, the most common skin tumor types (Villamill et al. 2011). They are benign tumors originating from adipose tissue and are common in middle‐aged to older dogs. They usually appear as soft, well‐circumscribed, smooth, subcutaneous singular masses on the trunk or proximal extremities. Other locations (thoracic, abdominal, intermuscular, intraosseous, and pericardial) have also been documented (Brambilla et al. 2006; Ben‐Amotz et al. 2007; Nakladal et al. 2012; Mayhew and Brockman 2002; Miles and Clarke 2001).

Although histologically benign, lipoma can be life‐threatening in some anatomical locations; McLaughlin and Kuzma (1991) described intestinal strangulation caused by intra‐abdominal lipomas, and Kolm et al. (2002) described an intrapericardial lipoma in a dog. Lipomas rarely recur after marginal surgical resection. Multiple lesions in one patient should be considered as separate tumors, not metastatic disease.

Thoracic and pelvic limb intermuscular lipoma have a similar prevalence. Most intermuscular lipoma of the limbs are located in the axilla and caudal thigh. Surgical excision of infiltrative lipomas of the limbs are mostly done by hand dissection after the skin and subcutaneous incisions to avoid nerve and large vessel damage with sharp instruments. Surgical treatment of intermuscular lipoma is associated with an excellent prognosis in dogs (Case et al. 2012).

Liposuction has been reported as treatment in dogs (Böttcher et al. 2007; Hunt et al. 2011). Liposuction was completely effective in removal of 96% of simple, encapsulated lipomas of less than 15 cm in diameter. Giant lipomas containing fibrous trabeculae hinder liposuction resulting in poor fat retrieval. Giant lipomas have been associated with a high risk of bruising, hematoma, and seroma, especially when inguinal in location. Regrowth has been reported between 9 and 36 months in 28% of lipomas after liposuction (Hunt et al. 2011).