Kitagawa Yasuyuki, Tamai Kensuke, Kim Yong, Hayashi Mikihiko, Makino Akira, Takai Shinro
Department of Restorative Medicine of Neuro-musculoskeretal System, Orthopaedic Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
J Nippon Med Sch. 2012;79(4):307-11. doi: 10.1272/jnms.79.307.
Lipoma of the finger is rare, and there have been few case reports of lipoma causing bone erosion in the finger. We report on a patient with a long-standing lipoma that caused deep erosion of the distal phalanx of the index finger. A 38-year-old man presented with a painful mass of the left index finger. Anteroposterior radiographic images showed a radiolucent area in slightly distal to the center of the distal phalanx. Magnetic resonance imaging revealed a large soft-tissue mass with high signal intensities and slight irregularity on both T1- and T2-weighted images which suggested lipoma. The patient underwent marginal excision of this tumor and curettage of the bone surface of the erosion. The pain resolved after surgery. The diagnosis of lipoma was confirmed with postoperative histological examination. Lipoma should be included in the differential diagnoses of a finger tumor, even if radiography shows bone erosion.
手指脂肪瘤较为罕见，关于脂肪瘤导致手指骨质侵蚀的病例报告很少。我们报告一例患有长期脂肪瘤的患者，该脂肪瘤导致示指远节指骨深部侵蚀。一名38岁男性因左示指疼痛性肿块就诊。前后位X线片显示在远节指骨中心稍远的部位有一个透亮区。磁共振成像显示在T1加权像和T2加权像上均有一个大的软组织肿块，信号强度高且稍有不规则，提示为脂肪瘤。患者接受了该肿瘤的边缘切除及骨质侵蚀表面的刮除术。术后疼痛缓解。术后组织学检查确诊为脂肪瘤。即使X线片显示骨质侵蚀，脂肪瘤也应列入手指肿瘤的鉴别诊断中。
