tumors

Question 1

ttt of lipoma

Answer 1

Surgical excision is indicated if a lipoma causing
trouble on account of its site, size, appearance or the presence of pain

Question 2

Types of neurofibroma:

Answer 2

1. Solitary neurofibroma:
2. Generalized neurofibromatosis (Von Recklinghausen’s disease of nerves):
   3- Acoustic neuroma
3. Plexiform neurofibromatosis
4. Elephantiasis neuromatosa:

Question 3

cystic hygroma

Answer 3

B. Cavernous lymphangioma
It usually occurs in the neck or axilla (cystic hygroma).
- It may affect the lips (macrocheilia) or the tongue (macroglossia) producing sometimes gross soft tissue swelling
ttt: excision

Question 4

C. Lymphangiosarcoma

Answer 4

Lymphangiosarcoma is a highly malignant tumour that arises from lymphatic endothelium. It can develop in lymphoedematous tissue (e.g. in lymphoedematous arm after modified radical mastectomy

Question 5

Glomus tumour

Answer 5

• glumos arrangement composed of a tortuous arteriole that communicates directly with a venule, the vessels being surrounded with a network of small nerves.
• Glomus tumour is a small, purple, compressible nodule, few millimeters in diameter that is disproportionately painful in response to insignificant stimuli (including cold exposure). Subungal varieties may be invisible causing paroxysmal digital pain.

ttt: excision

Question 6

Sinuses and Fistulae may be congenital

Answer 6

1- Congenital:

pre-auricular sinus,
branchial fistula,
tracheo-oesophageal fistula
and arteriovenous fistula

Question 7

Sinuses and Fistulae may be aquired

Answer 7

perianal abscess
arteriovenous fistula( renal dialysis)
thyroglossal fistula

Question 8

Stitch sinus

Answer 8

It is the result of non-absorbable suture material acting as a focus to a small infection within the wound

Healing of a persistent sinus requires the removal of the suture.

Question 9

Desmoid Tumour

Answer 9

• Desmoid tumors often appear as infiltrative, usually well-differentiated, firm over-growths of fibrous tissue, and they are locally aggressive. tendency for recurrence
• most commonly arise from the rectus abdominis muscle in postpartum women and in scars due to abdominal surgery

-oral contarceptives
- MRI is the investigation of choice
- ttt:watching and waiting, complete surgical removal, radiation therapy, antiestrogens and NSAIDs, or chemotherapy.

Question 10

Investigations and treatment of sinus and fistula

Answer 10

• Bacteriological and cytological examination of the discharge,

sinogram and fistulogram using water based contrast medium such as gastrographin,
C.T, MRI
and biopsy .
ttt: is directed towards the cause.

Question 11

ULCERS

Answer 11

Site:
size
shape
number
edge
floor
margins
discharge
pain?
vascular examintion :pulse>

Question 12

D. Kaposi’s Sarcoma

Answer 12

HIV infection.

• It starts as a red-brown, indurated, plaque-like skin lesion that become nodular and ulcerates.
• Treatment is by surgery and radiotherapy

Question 13

Capillary lymphangioma:

Answer 13

• It appears as a brown papule or wart-like projection, on which small vesicle can be seen on examination by a lens (lymphatic naevi).
• Treatment is by surgical excision.

Question 15

Pachy dermato cele

Answer 15

If Plexiform neurofibromatosis occurs in the face fifvth cranial nerve, the overlying skin sometimes hangs down in pendulous folds

Question 16

Von Recklinghausen’s disease of nerves c/p

Answer 16

there are no sensory or motor paralysis.

-There are cafe-au-lait patches of the skin, especially on the back

Question 17

Subsynovial lipoma / baker cyst

Answer 17

Differentiated from Baker’s cyst as its consistency is constant whether the joint
is extended or flexed.

Question 18

dangerous types of lipoma

Answer 18

subserous
retroperotinem

Question 19

Subcutaneous

Answer 19

ts capsule is attached to the skin and therefore dimpling of the skin over the tumour will be manifested especially on displacement of the swelling (lobulation).

• well defined slippery edge (slips away from the palpating fingers on pressure)