Definition & Overview
The excision of subcutaneous soft tissue tumours is the process of surgically removing abnormal growth found under the skin layer.
Connective tissues function to support, separate, or connect different organs and parts of the body. Areolar tissue is a type of loose connective tissue found underneath the skin or subcutaneously. It is quite flexible yet strong enough to attach and connect other types of tissues. It is also where numerous blood vessels supplying the skin are located. Apart from its subcutaneous location, areolar tissues are also found in the digestive and respiratory tracts.
Superficial tumour growths underneath the skin are quite common in occurrence and are classified according to their location and the age of the patient. Most mesenchymal tumours arise from the adipose or fat tissues under the skin. In most cases, imaging technologies are used to generate images of these tumours to make a diagnosis. Soft connective tissue tumours are typically benign but some can metastasise and became malignant.
Who Should Undergo and Expected Results
The excision of subcutaneous soft connective tissue can be recommended for patients diagnosed with:
Lipomas - This condition is a type of mesenchymal tumour that commonly occurs in adults. Most do not exhibit symptoms but there are cases in which this condition causes extreme pain and discomfort that could warrant excision.
Hemangiomas - These abnormal growths appear as red birthmarks and are asymptomatic. However, these tissues have the potential to grow and become unsightly protrusions into the skin.
Malignant fibrous histiocytomas – In some cases, malignant fibrous histiocytomas, which are a common complication of radiotherapy, occur subcutaneously and are removed through excision.
Epithelioid sarcoma – This is another malignant condition and is a type of slow-growing tumour that could occur in the subcutaneous soft connective tissue layer.
The excision of soft connective tissue tumours has a high success rate when used for the treatment of benign or noncancerous tissue growth. It is typically performed in an outpatient setting, which means that the patient is allowed to go home the same day but may need to come back for the removal of sutures.
For the excision of malignant tumours, the outcome is highly dependent on the extent of cancer spread and recurrence. The procedure is typically performed in conjunction with radiation or chemotherapy to increase the chances of achieving favourable outcomes.
How is the Procedure Performed?
Excision is an invasive surgical procedure and necessitates the use of local or general anaesthesia, depending on the type, size, and location of the tumour. The procedure can be performed using different techniques.
To start, the surgical site is identified and marked before the actual surgery commences. The surgeon then makes a small incision on the skin to access the tumour. A curettage procedure can be performed to remove the tumour growth within the capsule. The incision is typically left open to heal.
The surgeon can also choose to perform marginal excision in which the tumour is removed along with a margin of tissue surrounding it. This technique requires a larger incision resulting in a wound that has to be closed using sutures.
If there is a need to remove the tumour and a wide margin of healthy tissue surrounding it, the surgeon can perform a wide excision. This procedure helps ensure that the surrounding tissues do not develop the same condition.
In some cases, however, the surgeon may find the need to remove a good portion of the affected body part, including the surrounding muscles or nearby bone structures to halt tumour spread. This is termed radical excision and is typically performed in a hospital setting.
The excised tissue is then sent to a pathology laboratory for further evaluation.
Possible Risks and Complications
- Adverse reaction to anaesthesia
- Excessive bleeding, especially if blood vessels were injured or damaged
- Damage or injury to nearby nerves, leading to numbness or partial paralysis in the affected body part
- Infection of the surgical site
- Scarring, especially for large-sized tumour; these can be unsightly and may cause pain and discomfort
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