Carbone Stefano, Candela Vittorio, Passaretti Daniele, Cinotti Gianluca, Della Rocca Carlo, Giannicola Giuseppe, Gumina Stefano
Department of Orthopaedics and Traumatology, University of Rome Sapienza, Rome, Italy.
Musculoskelet Surg. 2012 May;96 Suppl 1:S53-6. doi: 10.1007/s12306-012-0190-7. Epub 2012 Apr 18.
We describe 13 consecutive cases of patients presenting with shoulder mass and limited function, and to whom we formulated a diagnosis of subdeltoid lipoma. Between 2002 and 2010, 14 patients had a diagnosis of subdeltoid lipoma. Of these, one was excluded from this review because of a concomitant cuff tear. Shoulder was evaluated with X-ray, MRI, EMG and pre-/post-operatively with constant score (CS) and subjective shoulder value (SSV). All patients had complete excision of the mass. Minimum follow-up was 12 months. In 14 cases, the lipoma was causing slight pain or discomfort, and in four cases (28.57 %), it was causing limitation of joint movement. EMG showed axillary nerve neuro apraxia in two cases (14.28 %). Preoperative CS and SSV were on average 80 and 80, respectively. At one-year follow-up, CS and SSV were meanly 92 and 95, respectively (p = 0.034). No recurrence of the lesion was noted. Subdeltoid lipomas quickly grow up and may cause compression of axillary nerve. Surgery is the treatment of these lesions if symptomatic. After complete excision, subdeltoid lipomas do not recur, and clinical signs disappear. Level of evidence Case series, Level IV.
我们描述了连续13例出现肩部肿块且功能受限的患者,我们对其诊断为三角肌下脂肪瘤。2002年至2010年间,有14例患者被诊断为三角肌下脂肪瘤。其中,1例因合并肩袖撕裂被排除在本综述之外。通过X线、磁共振成像(MRI)、肌电图(EMG)对肩部进行评估,并在术前和术后采用Constant评分(CS)和主观肩关节评分(SSV)。所有患者均接受了肿块的完整切除。最短随访时间为12个月。14例患者中,脂肪瘤引起轻微疼痛或不适,4例(28.57%)导致关节活动受限。肌电图显示2例(14.28%)存在腋神经神经失用。术前CS和SSV平均分别为80和80。在1年随访时,CS和SSV平均分别为92和95(p = 0.034)。未发现病变复发。三角肌下脂肪瘤生长迅速,可能导致腋神经受压。如果出现症状,手术是治疗这些病变的方法。完整切除后,三角肌下脂肪瘤不会复发,临床症状消失。证据级别:病例系列,IV级。