Lipomas: Risks, Symptoms, and Treatment Options

Questions about lipomas?

Hello Doctor: I have been experiencing mild numbness in my left foot for a year, occasionally accompanied by a tingling sensation.
After undergoing an MRI, it was discovered that I have a lipoma on my spine.
The doctor mentioned that surgery is the only treatment option, but it may "possibly" improve my symptoms.
Due to many news reports about spinal surgeries leading to paralysis, my family is opposed to the idea.
I would like to ask the doctor: 1.
A year ago, my foot was extremely numb, especially when sitting, which was very painful.
However, after a year, the numbness has significantly decreased but has not completely disappeared.
If the lipoma is the cause, could it have shrunk? 2.
If I do not undergo surgery, is there a possibility that my condition will worsen in the future? 3.
Is surgery truly the only option, or are there other treatment methods available? What are the risks associated with spinal surgery? Thank you for your response, Doctor!

Billy, 20~29 year old female. Ask Date: 2008/06/18

Dr. Zhang Yuanyi reply Neurosurgery

1.
The chance of a lipoma shrinking is low; there may be other underlying reasons.
2.
If the tumor enlarges and compresses the spine and nerves, it is indeed possible.
3.
The risk considerations vary depending on the location and size of the tumor.
Sincerely, Dr.
Zhang Yuan-chi, Attending Physician, Taoyuan Hospital, Department of Health.

Reply Date: 2008/06/18

More Info

Lipomas are benign tumors composed of adipose (fat) tissue. They are generally soft, movable, and painless, and can occur anywhere in the body, including the spine. When a lipoma develops in the spinal area, it can potentially compress nearby nerves, leading to symptoms such as numbness, tingling, or pain in the extremities, as you have experienced.

1. Symptoms and Changes Over Time: You mentioned that your symptoms have improved over the past year, with less numbness and discomfort in your left leg. This could be due to several factors. While lipomas typically do not shrink on their own, the surrounding inflammation or nerve irritation may have decreased, leading to an improvement in your symptoms. It’s also possible that your body has adapted to the presence of the lipoma, resulting in less noticeable symptoms. However, it’s essential to monitor any changes closely, as the condition can fluctuate.

2. Potential for Worsening: If the lipoma is indeed compressing a nerve, there is a possibility that symptoms could worsen over time, especially if the lipoma grows larger or if there is additional inflammation or degeneration in the spine. While many lipomas remain stable, some may grow, and if they begin to cause significant nerve compression, this could lead to more severe symptoms, including weakness or loss of function in the affected limb.

3. Surgical Intervention: Surgery is often recommended for symptomatic lipomas, particularly if they are causing nerve compression. While it is understandable that you and your family are concerned about the risks associated with spinal surgery, it is important to weigh these risks against the potential benefits. Surgical risks can include infection, bleeding, nerve damage, and, in rare cases, paralysis. However, many patients undergo successful surgeries with minimal complications.
Non-surgical options for managing symptoms may include physical therapy, pain management strategies, and monitoring the lipoma over time. However, these methods may not address the underlying issue if the lipoma is indeed causing nerve compression.
4. Consultation with Specialists: Given your concerns about surgery, it may be beneficial to seek a second opinion from a neurosurgeon or orthopedic surgeon who specializes in spinal conditions. They can provide a thorough evaluation of your specific case, discuss the potential risks and benefits of surgery, and explore any alternative treatment options that may be available.

In summary, while lipomas are generally benign, their location and size can impact nerve function and lead to symptoms. If your symptoms have improved, it may indicate a change in your condition, but ongoing monitoring is essential. Surgical intervention is often the most definitive treatment for symptomatic lipomas, but it is crucial to discuss all concerns and options with your healthcare provider to make an informed decision.

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