Lipomatöse Neoplasien im Kopf-Hals-Bereich

Lipogen differenzierte Tumore stellen mit einem Anteil bis zu 50% die größte Gruppe der benignen mesenchymalen Weichgewebstumore dar. Hiervon sind 13-17% im Kopf-Hals-Bereich lokalisiert. Ziel der vorliegenden Dissertation ist es, einen detaillierten Überblick über lipomatöse Neoplasien im Allgemein...

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Bibliographic Details
Main Author: May, Frederik
Contributors: Teymoortash, Afshin (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2017
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Mesenchymal neoplasms of lipogenic differentiation are the most common soft tissue neoplasms in adults. The aim of the study was to present a detailed overview of lipogenic neoplasms in general with a special focus on benign lipomatous lesions in the head and neck area. The clinical data of 77 patients over a period of ten years was retrospectively analyzed. The exact location of the Tumor and its symptoms as well as the diagnostic methods and treatment modalities were examined in detail. There were 58 men (75,3%) and 19 women (24,7%) ranging in age from 12 to 80 years with a mean age of 50,17. The assessment of the BMI showed that 72,7% of the patients were overweight and 29.9% were obese. Lipomatous lesions combined with underweight were not to be observed. Fifty-seven patients (71,3%) had superficial subcutaneous neoplasms and 23 (28,7%) were deep seated. Fifty per cent of the lipomatous lesions were found in the anterior Neck with the cervical lymph node level I and II as the most common sites. Further occurred 16,3% in the posterior neck, 8,8% in the auricular region and 6,3% in the parotid gland. The volume of the lesions ranged from less than 5 cm³ up to almost 500 cm³. Sonography has been used as an initial diagnosis procedure in 93,8% of the cases supported by magnetic resonance imaging (47,5%) and fine needle biopsy (52,5%). Simple extirpation was the standard treatment in 84,4% of the cases. Lipomas of the parotid gland region were resected via lateral parotidectomy (9,1%). Furthermore two wider excisions with the dimension of a neck dissection had to be performed. One patient with a deep seated neoplasm of the arytenoid cartilage region had to be treated by microlaryngoscopic support. Surgical resection was performed in endotracheal anesthesia in 88,5% and in 11,5% in local anesthesia. Operative neuromonitoring was used in 16,7% of the cases. Intraoperative complications in terms of nerve damage were observed in four Patients (5,1%). There were minor temporary paresthesias and one salivary duct fistula to be seen in the postoperative period. Histological subtypes were lipoma (87,5%), fibrolipoma (5%), spindle cell/pleomorphic lipoma (3,7%), intermuscular lipoma (2,5%) and angiolipoma (1,3%).