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Unusual presentation of more common disease/injury
CASE REPORT
Giant lipoma of the hand causing median nerve compression
  1. Kevin Clesham1,
  2. John Gerard Galbraith1,
  3. Ashok Ramasamy2,
  4. Ahmed Karkuri2
  1. 1Department of Orthopaedic & Trauma Surgery, Galway University Hospitals, Galway, Ireland
  2. 2Department of Orthopaedic & Trauma Surgery, Sligo University Hospital, Sligo, Ireland
  1. Correspondence to Dr Kevin Clesham, kevinclesham{at}gmail.com

Summary

Lipomas are benign neoplasms derived from adipose tissue composed of mature adipocytes. They account for almost 50% of all soft-tissue neoplasms and occur in up to 2% of the population. They usually present asymptomatically as solitary discrete mobile lumps found most commonly on the neck, upper back, proximal limbs and chest. In less than 1% of cases, they can be found in the distal extremities.

We discuss the case of a 65-year-old man who presented with a 2-year history of a slowly enlarging left palm swelling, with recent-onset numbness and loss of power in the distribution of the median nerve. MRI studies showed that the 5×4×2.7 cm lipoma had a component extending into the distal aspect of the carpal tunnel, compressing the median nerve. It was successfully excised, and at follow-up the patient reported complete resolution of his symptoms.

  • Orthopaedics
  • orthopaedic and trauma surgery
  • plastic and reconstructive surgery

https://doi.org/10.1136/bcr-2017-220056

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    Footnotes

    • Contributors KC researched the literature and drafted the case report after getting details about the case from the patient’s chart. KC was the main contributor to the writing of the report. JG assisted in obtaining the radiological images provided in the report, as well as guidance on the literary review and writing of the paper. AR identified the case and obtained the intraoperative images displayed in the report. AR also contributed to the planning, writing of the case and the literary review. AK was the consultant in charge and who carried out the procedure. AK assisted in the planning and writing of the paper as well as providing guidance on the literary review.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.