Shah Rushabh K, Rahman Shakeel M, Pywell Matthew, Ibanez Javier
Department of Plastic and Reconstructive Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK.
J Surg Case Rep. 2022 Jun 28;2022(6):rjac306. doi: 10.1093/jscr/rjac306. eCollection 2022 Jun.
Lipomas are the commonest benign tumour, made up exclusively of adipose tissue, and can arise anywhere in the body. However, giant lipomas of the hand, defined as >5 cm in diameter, are rare. They have the potential to invade into surrounding areas and cause a multitude of symptoms due to the compression and proximity of underlying structures. We describe a case of a 64-year-old woman who presents with a swelling of the left thenar eminence, associated with numbness and tingling in all fingers. Magnetic resonance imaging and nerve conduction studies confirmed the diagnosis of a lipoma causing median nerve compression. The patient underwent elective surgical excision with good postoperative recovery. The excised lesion, measuring 12 × 7 × 2.4 cm, is one of the largest giant lipomas of the hand reported in literature, and the first to demonstrate invasion from the mid palmar space into both the dorsal sub-aponeurotic space and carpal tunnel.
脂肪瘤是最常见的良性肿瘤，完全由脂肪组织构成，可发生于身体的任何部位。然而，直径大于5厘米的手部巨大脂肪瘤较为罕见。由于其对周围结构的压迫和邻近关系，它们有可能侵犯周围区域并引发多种症状。我们报告一例64岁女性患者，其左大鱼际隆起处肿胀，伴有所有手指麻木和刺痛。磁共振成像和神经传导研究证实诊断为脂肪瘤导致正中神经受压。患者接受了择期手术切除，术后恢复良好。切除的肿物大小为12×7×2.4厘米，是文献报道中最大的手部巨大脂肪瘤之一，也是首例显示从中掌间隙侵犯至背侧腱膜下间隙和腕管的病例。
