ONCODOC: Question about Lipomas Vs Skin Mets....

[Fay A.]

So many of us are diagnosed with Lipomas after a diagnosis of Lung Cancer, and then quite a few of us have subsequently learned that what we have/had was actually a subcutaneous skin met. How can we distinguish between the two when our Physicians will not biopsy? What do we look for?

There are clinical trials going on for the Lung Cancer vaccine where vaccine can be made from skin mets if they are large enough.

Thank you.

[kimblanchard]

I have to admit that I have been fooled by this myself. I had a patient with breast cancer, about 3 years out who developed what looked just like a sebaceous cyst on her back. It got bigger so I sent her to a surgeon to have it excised and it turned out to be a cutaneous met.

Lipomas are usually pretty easy to tell apart from mets though. They are below the skin, very soft and rubbery and should have been there for years. They should not be attached to the skin. Subcututaneous mets, while not necessarily hard, tend to be more firm. Lipomas also generally should have been there for a long time. If you have a history of cancer and one just suddenly shows up, I would think very much about biopsy. Doctors are reluctant to biopsy lipomas, however, because they really bleed a lot. You usually have to remove them completely and it can be kind of a big procedure.

[J.C.]

Thank you Fay for the question

Thank you Dr. Joe for the answer.

I have breast cancer since 1999 at the same time I got a lipoma

on my neck, 14 times I was refused test for it. (all accounted for

in my medical file)

Now the doctor will take it out next week and at the same time he will

do a cytologic examination (fine-needle aspiration) on the single thyroid

nodule I have.

Once more I had to raise h*** to get the examination I wanted.

Very unlucky with the medical system but I am still alive and I still

can kick. (hope to be after next week).

J.C.

[Fay A.]

Thank you, Dr. Joe, for answering. I have hard skin nodules popping up all over the place. My Mother also had BAC, and she had so many of these nodules that turned out to be skin mets. My docs keep telling me these are Lipomas, but they look and feel just like what my Mom had.

(I come from one of those Lung Cancer Families...multiple generations of both smokers and nonsmokers who develop Lung Cancer. My Mom and of her siblings died of Lung Cancer. I'm the third generation to have the disease).

[Harn]

Fay, thank you for clearing up something I didn't realize was common to many with lung cancer. I hadn't heard of anyone else developing these lipomas. Malignant skin lesions is something I am not aware of as it pertains to lc.

I just celebrated my 4th anniv post left lower lobectomy on Monday! YEAH. But I remember so well that 6 weeks past my surgery my husband and I were away and I happen to have noticed this huge lump on my right scapula in the hotel's full length mirror! I was absolutely stunned! Where did this huge thing come from? It was the size of a golf ball, no less. We said a quick goodbye to my daughter who was at school at William and Mary. Traveling north on 95 we called my surgeon at Penn who said come right in! They even waited for us at 6PM on a Friday night! He felt it was a lipoma (isn't that what old men get not a 50 year old woman, right?) but immediately had a Pathology doc take a biopsy to reassure me. Well, it stayed the same size until 2 years ago, all the while I would remind my surgeon on visits that he must have caused this when he did my initial surgery!! Fortunately, I could banter with him. But 2 years ago I noticed a change and I could actually feel it when I raised my arm and he said, okay he was so tired of hearing about it and would remove it. Well, he was really surprised at how large and ugly this thing really was..9cm(?) if I remember correctly..more like a tangerine-sized. He really was so great about removing it because typically you go to a general surgeon for these lipomas.

And to think I had it somehow connected with onset of menopause.

Interestingly, I heard recently how good selenium is but ,that, there is some correlation that there is a side effect in some people that it may cause skin cancers in susceptible people...anyone heard of this?