Matos Inês, Miragaia Luís, Florim Sofia
Department of Radiology, Vila Nova de Gaia Hospital Centre, Vila Nova de Gaia, Portugal.
Department of Orthopedics, Vila Nova de Gaia Hospital Centre, Vila Nova de Gaia, Portugal.
Radiol Case Rep. 2023 Aug 30;18(11):3959-3963. doi: 10.1016/j.radcr.2023.08.063. eCollection 2023 Nov.
Intraneural lipoma of the ulnar nerve is a rare peripheral nerve tumor in an uncommon location. Although its benign course, it can cause disabling symptoms such as pain, diminished sensation or paraesthesia, tenderness, and occasionally even loss of strength. We present the case of a middle age woman with insidious paresthesias and swelling of the hypothenar eminence of the left hand for over 1 year. A hand and wrist radiograph first confirmed a focal soft tissue mass with fat density and excluded potential bone lesions. Then, an ultrasound was performed that showed a slightly hyperechoic mass with a fibrillated pattern in contiguity with the proximal aspect of the ulnar nerve. The morphological arrangement of this mass, its location along ulnar nerve distribution and the main signal characteristics in magnetic resonance imaging such as hyperintensity in T1- and T2-weighted images and hypointensity in fat saturation sequences inferred an intraneural lipoma. Due to the progressive symptoms, elective resection of the lesion was performed with full recovery of the symptoms.
尺神经鞘内脂肪瘤是一种罕见的位于不常见部位的周围神经肿瘤。尽管其病程呈良性，但可导致致残症状，如疼痛、感觉减退或感觉异常、压痛，偶尔甚至肌力丧失。我们报告一例中年女性病例，其左手小鱼际肌隐匿性感觉异常和肿胀超过1年。手部和腕部X线片首先证实了一个具有脂肪密度的局灶性软组织肿块，并排除了潜在的骨病变。然后进行了超声检查，显示一个略高回声的肿块，呈纤维状，与尺神经近端相邻。该肿块的形态排列、其沿尺神经分布的位置以及磁共振成像中的主要信号特征，如T1加权和T2加权图像上的高信号以及脂肪抑制序列上的低信号，提示为神经鞘内脂肪瘤。由于症状逐渐加重，对病变进行了择期切除，症状完全恢复。
