Lalchandani Rajesh, Venkatesh Kumar S, Sahu Vaibav, Garg Gaurav
Department of Orthopedics, ESI-PGIMSR Model Hospital, Basaidarapur, New Delhi, India.
J Clin Orthop Trauma. 2020 Jul-Aug;11(4):668-671. doi: 10.1016/j.jcot.2020.03.005. Epub 2020 Mar 13.
Lipomas are benign soft masses of adipose cells, which are often encapsulated by a thin layer of fibrous tissue and are most commonly present in head, neck, shoulders, and backs of patients. The tumors typically lie in the subcutaneous tissues of patients. Inter-muscular lipomas however, are rare and always occur deep within muscle compartments comprising 0.3% of all lipomas. Deep lipomas are most commonly found in the lower limbs followed by trunk, shoulders and arm. We present a rare case of deep dorsal inter-compartmental inter-muscular giant lipoma (>8cm) of right distal forearm leading to the formation of ganglion in the tendon sheath of Flexor Carpi Radialis (FCR) of anterior compartment as a result of breaching of inter-osseous membrane. MRI findings were indicative of a benign inter-compartmental lipoma of dorsal aspect of right distal forearm that erodes through distal inter-osseous membrane to enter the distal volar aspect of the wrist and therefore we did an excision biopsy and histo-pathological examination of the swelling reported an encapsulated tumour composed of mature adipose cells, which were uniformly arranged without high variations in size, consistent with benign lipoma. To the best of our knowledge, after an extensive search of literature we present this rare case of deep dorsal inter-muscular lipoma of forearm crossing over to the volar compartment resulting in ganglion formation in FCR tendon sheath.
脂肪瘤是脂肪细胞构成的良性软组织肿块,通常被一层薄纤维组织包裹,最常见于患者的头部、颈部、肩部和背部。肿瘤通常位于患者的皮下组织。然而,肌间脂肪瘤很少见,总是发生在肌间隙深部,占所有脂肪瘤的0.3%。深部脂肪瘤最常见于下肢,其次是躯干、肩部和手臂。我们报告一例罕见的右前臂远端深部背侧肌间巨大脂肪瘤(>8cm),由于骨间膜破裂,导致前侧间室桡侧腕屈肌腱鞘内形成腱鞘囊肿。MRI表现提示右前臂远端背侧良性肌间脂肪瘤,该脂肪瘤侵蚀远端骨间膜进入腕部远端掌侧,因此我们对肿胀部位进行了切除活检,组织病理学检查报告为一个由成熟脂肪细胞组成的包膜肿瘤,脂肪细胞排列均匀,大小无明显差异,符合良性脂肪瘤。据我们所知,在广泛查阅文献后,我们报告了这例罕见的前臂深部背侧肌间脂肪瘤,该脂肪瘤延伸至掌侧间室,导致桡侧腕屈肌腱鞘内形成腱鞘囊肿。