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Surgery M4 part 1 > SC swellings > Flashcards

SC swellings Flashcards

1
Q

What’s the name of the benign tumor arising from adipose tissue that could occur anywhere in the body except the brain?

A

LIPOMA

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2
Q

What are the special types of lipoma?

A
  • Neurolipoma: painful
  • Dercum’s disease (adiposis dolorosa): tender deposition of fat on the trunk (diffuse lipoma)
  • Fibrolipoma: lipoma with fibrous content
  • Naevolipoma: lipoma with telangiectasis
  • Lipoma arborigens: pedunculated lipoma
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3
Q

What lipoma is most liable to turn into a sarcoma?

A

retroperitoneal lipoma

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4
Q

A lipoma at what site is LEAST liable to turn malignant?

A

subcutaneous (most common)

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5
Q

A lipoma in the submucosa of the GI tract will cause?

A

intassusseption

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6
Q

an extradural lipoma will lead to?

A

spinal canal compression

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7
Q

What are the clinical features of a lipoma?

A
  • localized swelling
  • lobular & non tender
  • slippery edge (mobile)
  • skin is free
  • may be pedunculated (LIPOMA ARBORIGENS)
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8
Q

What are the complications of a lipoma?

A
  • sarcomatous changes: LIPOSARCOMA (retroperitoneum)
  • myxomatous change
  • calcification
  • submucosal lipoma causes intussusception leading to intestinal obstruction
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9
Q

How is a lipoma treated?

A
  • enucleation

- (liposarcoma) wide excision with adjuvant chemotherapy & radiotherapy

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10
Q

What is the classification of cysts according to their wall?

A

TRUE (epithelial lining)
- abscess

FALSE (not lined by epithelium)

  • cystic degeneration of tumor
  • hematoma
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11
Q

What are the types of dermoid cysts and what is their lining?

A 
lined by STRATIFIED SQUAMOUS EPITHELIUM 
1- sequestration dermoid cyst 
2- implantation dermoid cyst 
3- tubulodermoid cyst 
4- teratomatous dermoid cyst
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12
Q

What are the sites of the development of a sequestration dermoid cyst?

A

ALONG LINE OF EMBRYONIC FUSION

  • HEAD -> external & internal angular
    - > pre & post auricular
  • NECK & TRUNK: anywhere in midline or in line of fusion

NEVER occurs in LIMBS

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13
Q

What are the clinical features of a sequestration dermoid cyst?

A
  • painless cyst in anatomical sites
  • opaque
  • not attached to skin
  • resorption & indentation of bone beneath
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14
Q

What investigation & treatment should be done for a sequestration dermoid cyst?

A
  • X-ray/CT to confirm any indentation

- surgical excision

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15
Q

What type of cyst will result from minor pricks or trauma? What is their most common site?

A

IMPLANTATION DERMOID
- epidermis gets buried into deeper subcutaneous which will cause reaction & cyst formation

common in fingers (tailors & gardeners)

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16
Q

What are the clinical features of a implantation dermoid cyst? Treatment?

A
  • painless
  • slowly progressing in fingers or toes
  • smooth mobile, tensely cystic
  • nontransilluminating
  • adherent to skin

remove by surgical excision

17
Q

what cyst arises from embryonic tubular structures?

A

TUBULODERMOID CYST

- like thyroglossal cyst

18
Q

What cyst can arise from all germinal layers?

A

TERATOMATOUS DERMOID

  • occurs in ovary, testis, retroperitoneum, mediastinum
  • contains hair, teeth, cartilage & muscle
19
Q

retention cyst due to blockage of the duct of sebaceous gland, has a punctum & skin overlining can’t be pinched is called?

A

SEBACEOUS or EPIDERMOID CYST

  • common in scalp, face
  • not seen in palms & soles (no hair follicles)
20
Q

What are the clinical features of a sebaceous cyst?

A
  • painless swelling
  • smooth
  • nontender
  • freely mobile but attached to skin
  • FLUCTUANT (positive Paget’s test)
  • nontransilluminating
  • punctum
21
Q

What are the complications of an epidermoid (sebaceous) cyst?

A
  • hair loss
  • infection & abscess formation (most common)
  • surface gets ulcerated -> painful fungating mass with discharge (Cock’s peculiar tumor)
  • sebaceous horn: hardening of slowly discharged sebum
22
Q

How should a sebaceous cyst be treated?

A
  • elliptical excision (including skin adjacent to punctum) if its simple
  • if its an abscess -> incision first & drainage later
  • if capsule is not removed properly cyst will recur
23
Q

How should a sebaceous cyst in the scrotum be treated?

A

partial or total scrotectomy

24
Q

Benign tumor that arises from covering sheath of nerves?

A

NEUROFIBROMA

25
Q

What are the clinical features of a neurofibroma?

A
  • subcutaneous
  • single or multiple
  • firm
  • not attached to skin
  • moves across not along nerves
  • CAFE AU LAIT PATCHES
26
Q

What are the complications & treatment of neurofibroma?

A

MALIGNANT TRANSFORMATION -> neurofibrosarcoma

- surgical excision

27
Q

What are the special types of neurofibroma?

A
  • generalized neurofibromatosis: sporadic or part of MENIIB (only treat symptomatic)
  • acoustic neuroma: shwannoma arising from root of 8th cranial nerve (vestibulocochlear)

Surgery M4 part 1 (47 decks)

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