Retroperitoneal lipoma

　　Retroperitoneal lipoma is also known as primary retroperitoneal lipoma, renal or primary retroperitoneal extrarenal visceral lipoma, that is, not including lipomas occurring in solid organs such as the kidney, adrenal glands, and pancreas. So far, the cause of the disease has not been clarified. Retroperitoneal lipoma is a benign tumor of limited fatty tissue proliferation in the retroperitoneal space. Macroscopically:呈扁圆形分叶状. There is a capsule, soft texture, cross-section is light yellow, the size of the tumor is not uniform, ranging from a few centimeters to the size of a child's head or even larger, often solitary, can also be multiple. Microscopically, the structure is the same as normal fat tissue, the main difference being the presence of a capsule, the irregular size of the lobes of the tumor, and the existence of unequal fibrous tissue septa. The growth of this tumor is slow.

　　1. Compression of adjacent organs can cause obstruction of hollow organs.

　　2. If nerves are compressed, it may manifest as lumbar and sacral pain, perineal pain, and lower limb pain, and there may also be sensory reduction and numbness in the areas innervated by related nerves.

　　1. Symptoms caused by compression of adjacent organs: Severe cases can cause obstruction of hollow organs, gastrointestinal symptoms include nausea, vomiting, rectal irritation may lead to increased frequency of defecation, urgency, and a sinking feeling. Urological symptoms include frequent urination, urgency, hematuria, difficulty in urination, renal pelvis hydrops, and even uremia. Pain symptoms, if the nerves are compressed, may manifest as lumbar and sacral pain, perineal pain, and lower limb pain. There may also be sensory reduction and numbness in the areas innervated by related nerves.

　　2. Symptoms of mass: The tumor grows large, causing abdominal distension in patients, which may affect breathing. When it grows in the pelvic cavity, it may cause a feeling of坠胀.

　　The etiology of retroperitoneal lipoma is not yet clear.

　　1. Do not smoke or drink alcohol, which is one of the most important aspects of preventing lipoma.

　　2. Regular lifestyle, do not stay up late.

　　3. Mental health, do not get angry or depressed.

　　4. Regular diet.

　　Breakfast should be well: Regular diet and a good breakfast are extremely important for patients with lipoma. If breakfast is skipped, it can stimulate the lipoma or cause the original tumor to increase in size and quantity. Therefore, the best breakfast should include foods rich in vegetable oil, which is important for preventing lipoma.

　　5. Low cholesterol diet.

　　Excessive intake of cholesterol can increase the metabolic and cleaning burden of organs, and cause excess cholesterol to accumulate and precipitate under the skin or in the internal organs, thus forming lipoma. Therefore, patients with lipoma should reduce their intake of cholesterol, especially at night, and avoid eating high-cholesterol foods such as meat products, with a daily limit of less than 75g. The best choices are lean pork and chicken or duck meat with the skin removed, but it should be avoided to eat fatty meat, the skin of chicken or duck, and processed meat products (such as sausages). In addition, fish roe, squid, and animal internal organs such as liver, brain, kidney, lung, stomach, and intestines should be strictly limited.

　　6. Abstain from alcohol and alcoholic beverages.

　　Alcohol is mainly metabolized and detoxified by the liver, so alcohol can directly damage liver function, cause liver and gallbladder dysfunction, disrupt the secretion and excretion process of bile, and thus stimulate the formation of lipoma and/or cause the original tumor to grow larger, increasing the risk of lipoma malignancy.

　　7. Pay attention to light taste in diet and eat more fresh vegetables and fruits.

　　Eat less beef, mutton, dog meat, chicken, fish and shrimp, chili, and other spicy foods, and eat less greasy, fried, pickled, and smoked foods, etc.

　　8. Keep the bowels regular, once a day.

　　1.CT has higher accuracy than ultrasound, with a detection rate of 89%. It shows a more intuitive and clear location, size, extent, and relationship with adjacent organs of the tumor. Enhanced scanning can show the relationship between the tumor and surrounding blood vessels. The presence of fat density is a characteristic of the tumor.

　　2..Magnetic resonance imaging is superior to CT in identifying the extent of the tumor and its relationship with surrounding tissues and blood vessels.

　　3. Selective arterial angiography: Vessels can be displaced, which is meaningful for the localization of retroperitoneal tumors and understanding the blood supply of the tumor, but it is not specific.

　　4. Barium meal and barium enema for gastrointestinal tract: Can exclude gastrointestinal tumors. When the tumor is large enough, it can be found that the gastrointestinal tract is displaced or twisted, the mass is located in the lower abdomen, and the small intestine can move upwards or to one side; when the mass is located in the upper abdomen, the small intestine and transverse colon move downwards. The detection rate of this examination is below 50%.

　　5. Renal pelvis and ureterography, retrograde renal pelvis and ureterography: Most cases have displacement, compression of renal pelvis, ureter, and bladder. The detection rate is 66%.

　　6..Ultrasound can clearly define the location, size, number, and relationship with surrounding organs of the tumor, and understand whether the tumor is solid or cystic. The detection rate is 80%.

　　Appropriate foods: Increase the proportion of fiber-rich foods, vegetables, fruits, and cereal foods in the diet, with an intake of dietary fiber greater than 30g/day, and animal internal organs.

　　食疗：生薏米对多发性脂肪瘤有一定治疗作用。患者可服用薏米粥治疗。具体方法如下：生薏米100-120克，每日煮粥一次，1-2次吃完，30天一个疗程。

　　Dietary therapy: raw Coix seed has a certain therapeutic effect on multiple lipomas. Patients can take Coix seed porridge for treatment. The specific method is as follows: 100-120 grams of raw Coix seed, boil once a day, eat 1-2 times, and one course of treatment is 30 days.

　　The conventional method of treating retroperitoneal lipomas in Western medicine

　　Traditional Chinese medicine points out that lipomas are often caused by stagnation and injury to the spleen, and the condensation of phlegm and Qi. The treatment of lipomas in traditional Chinese medicine focuses on strengthening the spleen and Qi, and regulating Qi to resolve phlegm.

　　For those with Qi deficiency, it is advisable to strengthen the spleen and Qi, resolve phlegm, and disperse nodules.

　　For those with Qi stagnation, it is advisable to relieve liver Qi stagnation, resolve phlegm, and disperse nodules.

　　For those with blood stasis, the following medicinals can be used: 15 grams of Angelica sinensis, 12 grams each of dried tangerine peel, white peony root, and white peony root, 10 grams each of Wu ye, Sichuan chuanxiong, Cyperus rotundus, Citrus aurantium, and Costus, 6 grams of licorice, 5 dates, and 3 slices of ginger.

　　For those with phlegm, the following medicinals can be used: (1) Erchen Wan, 3 grams each time, twice a day. (2) Xiaojin Tablet, 4 tablets each time, three times a day. External application can use Xiaoyong Gao (equal parts of borax and myrrh, a little musk, ground into a paste with garlic, and applied with vinegar or ginger juice). It can also be used by grinding Shengxing and Fumistera officinalis into fine powder, mixed with egg white and vinegar, and applied. It is also important to avoid overwork, maintain a cheerful mood, and get enough sleep; live a regular life, eat light food, and eat more fresh vegetables and fruits; strictly limit rich and greasy foods, quit smoking and drinking.

　　Three, strengthen the spleen, resolve phlegm, and activate blood circulation to remove blood stasis.

　　For those with dampness and phlegm, add 10 grams of Atractylodes macrocephala, 15 grams of Poria cocos, 12 grams of Zhebe, 12 grams of Platycodon grandiflorus, and 18 grams of Prunella vulgaris.

　　For those with phlegm, add 6 grams of dried tangerine peel, 12 grams of Daphne leaves, 10 grams of Angelica sinensis, 18 grams of Astragalus membranaceus, 15 grams of Codonopsis pilosula, and 18 grams of Coix seed.

　　[Addition and subtraction]:

　　For those with edema throughout the body, add 15 grams of Poria cocos and 12 grams of Alisma orientale.

　　For those with hard tumors, add 18 grams of Belamcanda chinensis, 12 grams of Curcuma, and 12 grams of Banyan.

　　For those with loose stools, add 12 grams of Myristica fragrans, 15 grams of Shengjie, and 10 grams of Hoelen.