Surgical correction of subcutaneous lipomas in the tail of buffalo: A case report

Introduction

Lipoma (Non-cancerous) is a benign tumor arising from fat cells which may be either adult type or of mature fat cells. Typically lipoma is a soft, rubbery lump located just beneath the skin. The growth of lipoma is gradual and painless in nature. Lipomas are common subcutaneous tumors composed of adipose cells, often encapsulated by a thin layer of fibrous tissue (Kosztyuova et al., 2017) [4] . Neoplasms of adipose tissue are rare in buffaloes and if it is, single and localized lipoma in the abdominal cavity is more common (Ozmen, 2005) [5] . Surgical excision is the choice of treatment for lipoma (Veena, 2013) [6] . Generally subcutaneous lipoma is a harmless growth but may get converted to carcinoma. In this case these are slow-growing a soft doughy lump easily movable on touch. These are composed of fat cell mass oval, encapsulated, surrounded by a thin layer of fibrous tissue. Lipomas are commonly detected after maturity at the age of 3 rd -4 th calving. Usually they do not cause health issues unless it presses any nerve, develops near the joint, encroaches on blood vessels or impacts an organ's function. Treatment for lipomas include surgical removal, steroid injections or laser therapy if it becomes bothersome, painful or continues to grow. In bovine, tail has an important role during locomotion, communication, and stay warm, to swat flies and other irritations (Fraser & Broom, 1997) [3] . In this case the price of animals was getting depreciated due to this multiple growth. So we opted for surgical intervention for a permanent solution.

Clinical signs

On ventral side of tail at the junction of 3 rd , 4 th and 5 th coccygeal vertebrae (Figure 1), three consecutive, subcutaneous moving masses were placed like "string of pearls" in decreasing order of size at the tail of the buffalo. As per history, its size was increasing day by day.

Diagnosis

On fine needle aspiration of subcutaneous moving mass no fluid was drained. Only greasy sticky material with no smell came in the core of the needle.

Surgical management

Surgical correction was done in a standing position in Travis under epidural anesthesia. At 1 st intercoccygeal space, 5 ml 2% Lignocaine injection & 1.5 ml at the site of incision was administered for complete loss of sensation at the site of incision. Masses were incised at the mid ventral line of tail. After excision of the first mass 'a' incision (Figure 2) line was increased up to mass 'b' & 'c'. Although there was no bleeding from the stump of the incised masses. For prevention of any further growth by flare of blood supply from base of stump of mass a, & b were ligated with catgut suture No 1/0. No ligation was required at the base of mass c due to negligible stump size. Skin was sutured with nylon no 1 in a horizontal mattress pattern. On the cut surface encapsulated, movable, oval shaped masses were found. Masses were well demarcated with other tissues due to their firm consistency and white-yellowish color. All three masses were in separate capsules of size ranging from 2 cm to 0.5 cm. Regular antibiotics for 5 days along with localized antiseptic dressing with topical dressing spray resulted in complete recovery and skin sutures were removed on day 11 th .

Results and Discussion

Lipoma can be classified as simple lipoma, fibrolipoma, spindle cell lipoma, intramuscular or infiltrating lipoma, angiolipoma, pleomorphic lipoma, myxoid lipoma, and atypical lipoma. Intramuscular or infiltrating lipoma is an uncommon mesenchymal tumor, usually appearing in the extremities or trunk. The effect of blunt trauma on fat tissue may be explained by different theories. In this case, tumorlike growths were well differentiated as a nodular mass in the subcutis. Radical excision of tumor was applied in such cases as a curative intervention (Abouelnasr et al., 2016) [1] . These masses have most of the similarity with lipoma. Lipomas tend to rupture and thereby increase the probability of getting infested with myiasis Baniadam et al. (2010) [2] . the treatment of choice in such type of cases which was performed in this case also.

References

1. Abouelnasr K, El-Sayed El-Shafaey, Mosbah E, ElKhodery E. Utility of ultrasonography for diagnosis of superficial swellings in buffalo. The Journal of Veterinary Medical Science. 2016;15:629.
2. Baniadam A, Navid M, Babak M. Nasal squamous cell carcinoma in a cow. Turkish Journal of Veterinary and Animal Sciences. 2010;34(3):303-305.
3. Fraser AF, Broom DB. Farm animal behaviour and welfare. London: CAB International; 1997, p. 437.
4. Kosztyuova T, Shim TN. Rapidly enlarging lipoma. BMJ Case Reports. 2017;2017:bcr-2017-220367, p. 1-2.
5. Ozmen O. Congenital lipomatosis in a Brown Swiss calf. Revue de Médecine Vétérinaire. 2005;156(4):191-193.
6. Veena P, Bharathi S, Devarathnam J. Surgical management of lipoma in a dog. Intas Polivet. 2013;14(2):475-476.