Accurate diagnostic algorithm for patients with rare pathology of thenar intramuscular lipomas

Intramuscular lipomas which are classified as the subgroup of infiltrative lipomas histologically, are seen rare in the hand. They often localized at the thenar eminence when they do occur in the hand. In such locations, lipomas must differentiate from ganglion cysts which is the most common hand mass. They may cause certain complications due to median nerve entrapment as ganglion cysts. Magnetic resonance imaging and histopathologic investigation are the most effective and reliable methods of confirming the diagnosis. Five patients with the symptoms of mild thumb pain, numbness in the radially innervated digits of hand, and difficulty while gripping objects were included in this study. Radiological assessment included plain radiography, ultrasonography (USG), magnetic resonance imaging (MRI) and electromyography (EMG). Excisional biopsy for all masses within marginal borders were performed. Pathological results revealed intramuscular lipomas. All symptoms were disappeared after excision of the masses. No recurrence and complication was observed at final follow-ups. Intramuscular lipomas are benign lesions with an excellent prognosis after adequate excisions and after clinical suspicious, algorithmic imaging approach in diagnosis can be used by any physician easily as we mentioned in the study.

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Grivas TB, Psarakis SA, Kaspiris A, et al. Giantlipoma of the thenar-case study and contemporary approach to its aetiopathogenicity. Hand (N Y). 2009;4:173-6.

Inampudi P, Jacobson JA, Fessell DP, et al. Soft-tissue lipomas: accuracy of sonography in diagnosis with pathologic correlation. Radiology. 2004;233:763-7.

Ivan Cherney, Spencer Tingey. Thenar intramuscular lipoma: A case report. J Med Cas. 2013;4:676-8.

Mohan L, Semoes J. Thenar intramuscular lipoma: an unusual case. Intern J Surg. 2007;7:

Han HH, Choi JY, Seo BF, et al. Treatment for intramuscular lipoma frequently confused with sarcoma: a 6-year retrospective study and literature review. Biomed Res Int. 2014;2014:867689.

Myhre-Jensen O. A consecutive 7-year series of 1331 benign soft tissue tumors: clinicopathologic data. Comparison with sarcomas. Acta Orthop Scand. 1981;52:287-93.

l-Qattan MM, Al-Lazzam AM, Al Thunayan A, et al. Classification of benign fatty tumors of the upper limb. Hand Surgery. 2005;10:43-59.

Weiss SW, Goldblum JR. Benign lipomatous tumors. In: Weiss SW, Goldblum JR, editors. Enzinger and Weiss’s Soft Tissue Tumors. 4th ed. St Louis, MO: CV Mosby Co; 2001:571–639.

Zamora MA, Zamora CA, Samayoa EA, et al. High-resolution ultrasonography in an aggressive thenar intramuscular lipoma. J Ultrasound Med. 2005;24:1151-5.

Lee YH, Jung JM, Baek GH, et al. Intramuscular lipoma in thenar or hypothenar muscles. Hand Surgery 2004;9:49-54.

Cribb GL, Cool WP, Ford DJ, et al. Giant lipomatous tumours of the hand and forearm. The Journal of Hand Surgery: British European Vol. 2005;30:50912.

Schoffl H, Hager D, Dunst KM, et al. Giant lipoma of the thenar. Wiener Klinische Wochenschrift 2007;119:149-9.

Arajy ZY. Palmar lipomas; different clinical presentations. Iraqi Postgraduate Med J. 2008;7:285-9.

McTighe S, Chernev I. Intramuscular lipoma: a review of the literature. Orthop Rev. 2014;6:5618.

Su CH, Hung JK, Chang IL. Surgical treatment of intramuscular, infiltrating lipoma. Int Surg. 2011;96:56-9.

Sandberg AA. Updates on the cytogenetics and molecular genetics of bone and soft tissue tumors: lipoma. Cancer Genet Cytogenet. 2004;150:93115.

Otsuka H, Terazawa K, Morita N, et al. Thallium-201 chloride scintigraphy in soft tissue tumors. J Med Invest. 2009;56:136-41.

Higgs PE, Young VL, Schuster R, et al. Giant lipomas of the hand and forearm. South Med J. 1993;86:887-90.

Regan JM, Bickel WH, Broders AC. Infiltrating benign lipomas of the extremities; report of two cases. Proc Staff Meet Mayo Clin. 1946;21:175.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
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