Mr Morritt regularly performs surgery in Sheffield to remove lumps such as lipomas (fat lumps), sebaceous cysts and nerve tumours (schwannomas). As the vast majority of these lumps are relatively small and superficial, surgery can generally be performed under local anaesthetic as a daycase procedure (go home the same day). In the rare instances where lumps are either very large or are deeply located, general anaesthetic and an overnight stay in hospital may be required.
Mr Morritt frequently removes lipomas. These are common benign fatty lumps that grow slowly and tend to be painless. We do not know yet what causes lipomas although they do sometimes run in families suggesting a genetic cause. Lipomas can sometimes be painful (this is more common with ‘angiolipomas’). The vast majority of lipomas are small and are located immediately under the skin so can be moved around freely. These shallow lipomas can usually be removed through very small scars under local anaesthetic.
Lipomas can also be deeply sited both within muscles or underneath muscles. In certain locations or for large lipomas it is necessary for surgery to be performed under general or regional anaesthetic (such as spinal anaesthesia). Sometimes lipomas can grow to massive sizes e.g. the size of a watermelon. Mr Morritt has considerable experience in removing all lipomas and regularly undertakes surgery to remove lipomas from complex areas such as those located near major blood vessels or nerves.
Case 1. Photos showing appearances before and 6 weeks after removal of a large lipoma (fat lump) in the subcutaneous tissues of this lady’s tummy. Lumps like this grow slowly and stretch the skin so when they are removed it is often necessary to remove the excess skin. This lady had the lump removed under general anaesthetic (she was asleep for the procedure) because it was large and deeply located.
Atypical lipomatous tumour (ALT)
A rarer fatty lump that can be mistaken for a lipoma is called an atypical lipomatous tumour (ALT or well differentiated liposarcoma). These are very similar to lipomas but regrow more frequently after they are removed. This diagnosis should be considered for all fatty lumps that measure greater than 5cm and are deeply sited. These lumps are a specialist area that is managed within the Sarcoma MDT. Mr Morritt is a core member of the sarcoma MDT and regularly removes these lumps.
Mr Morritt regularly treats patients with Dercum’s disease (multiple lipomas; also known as adiposis dolorosa). Sometimes these patients can have hundreds of lipomas. It is often not feasible to remove all the lipomas in the whole body from patient’s with Dercum’s disease as there are so many lumps. Mr Morritt therefore tends to recommend removal of any lumps that are painful, those that catch on clothing, those on cosmetically sensitive areas and those lipomas that are larger (typically greater than 5 cm diameter). Other lipomas can be removed for cosmetic reasons if patients desire.
Sebaceous cyst removal (Epidermoid cyst)
Mr Morritt frequently removes sebaceous cysts. These are cysts that occur in skin on areas of the body where there is hair. The typically range from the size of a pea to the size of a marble but can sometimes be much larger. Sebaceous cysts are very common and are benign. Rarely, if the cyst is subject to repeated inflammation or infection over many years, they can turn into a type of skin cancer called SCC (squamous cell carcinoma). Often patients may have squeezed the cysts thinking they are spots revealing the contents which are like cottage cheese and can smell. It is best not to squeeze these cysts because this makes them harder to remove surgically. Contrary to popular videos online where the cysts are lanced and their contents squeezed out, the best treatment is for the whole cyst to be removed. We know from experience that leaving the shell or part of the shell of the sebaceous cyst increases the chance of the cyst growing back.
Removal of nerve lumps
Mr Morritt regularly removes nerve lumps. These are most frequently benign lumps. They are often called peripheral nerve sheath tumours (PNST’s) or schwannomas. PNST’s arise from nerves and are generally benign although rarely can be malignant (cancerous). Nerve lumps are typically very tender and tapping them may result in electric shock type feelings. Sometimes PNSTs can arise on major nerves in the body and Mr Morritt is experienced in removing nerve lumps in that situation. Rarely complete removal of a nerve lump may result in the removal of part of or the whole nerve and in that situation Mr Morritt can undertake reconstructive surgery to rebuild the nerve with a nerve graft which is a piece of nerve taken from elsewhere on the body. A very rare condition exists called MPNST (malignant peripheral nerve sheath tumour) which is a cancerous nerve lump. MPNST typically requires major surgery and radiotherapy for treatment.
Another type of nerve lump is called a neurofibroma. These benign lumps are generally fleshy tags on the skin and can be removed with minor surgery. Some patients may suffer from a condition called neurofibromatosis where their whole body may be covered in neurofibromas. Rarely the neurofibroma may grow on a major nerve and removal typically requires reconstructive surgery to rebuild the nerve.