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Case Reports
. 2022 Jun 28;2022(6):rjac306.
doi: 10.1093/jscr/rjac306. eCollection 2022 Jun.

Management of a rare, giant multicompartmental lipoma of the hand: a case report and review of the literature

Rushabh K Shah  1 , Shakeel M Rahman  1 , Matthew Pywell  1 , Javier Ibanez  1
Affiliations
Case Reports

Management of a rare, giant multicompartmental lipoma of the hand: a case report and review of the literature

Rushabh K Shah et al. J Surg Case Rep. .

Abstract

Lipomas are the commonest benign tumour, made up exclusively of adipose tissue, and can arise anywhere in the body. However, giant lipomas of the hand, defined as >5 cm in diameter, are rare. They have the potential to invade into surrounding areas and cause a multitude of symptoms due to the compression and proximity of underlying structures. We describe a case of a 64-year-old woman who presents with a swelling of the left thenar eminence, associated with numbness and tingling in all fingers. Magnetic resonance imaging and nerve conduction studies confirmed the diagnosis of a lipoma causing median nerve compression. The patient underwent elective surgical excision with good postoperative recovery. The excised lesion, measuring 12 × 7 × 2.4 cm, is one of the largest giant lipomas of the hand reported in literature, and the first to demonstrate invasion from the mid palmar space into both the dorsal sub-aponeurotic space and carpal tunnel.

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Figures

Figure 1
Figure 1
Axial MRI view demonstrating volar and dorsal extension of the fatty lesion from the middle of the palm.
Figure 2
Figure 2
Coronal section demonstrating small proximal extension into carpal tunnel with resultant median nerve compression.
Figure 3
Figure 3
Intraoperative images demonstrating the relationship of the lesion with the surrounding neurovascular structures.
Figure 4
Figure 4
Final specimen measuring 12 × 7 × 2.4 cm.
See this image and copyright information in PMC

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