Mazur Marc D, Natroshvili Tinatin, Jongen Sandra J M, Kemler Marius A
Department of Plastic Surgery, Martini Hospital Groningen.
Case Reports Plast Surg Hand Surg. 2024 Jan 18;11(1):2303997. doi: 10.1080/23320885.2024.2303997. eCollection 2024.
Female, 58-year-old.
Benign recurrent lipoma following incomplete surgical removal.
Discomfort, Aesthetic Dissatisfaction.
Surgical Revision-Excision-Exploration with Lipoma Extraction.
Plastic Surgery (Hand Surgery).
Unusual Clinical Presentation and Course.
Lipoma is a usually painless tumor composed of adipocytes, of fat cells, arising from mesenchymal tissue. It manifests itself in locations in the body where adipocytes are and has circumscribed growth. Its incidence in the hand is relatively low (1%-4.9%). Despite most lipomas being benign and usually asymptomatic, the location of lipoma can lead to nerve compression symptoms. We report a case of an unusual recurrence of lipoma in the wrist after incomplete excision.
A 58-year-old female presented with a large, soft mass located on the volar side of the wrist, which recurred during the first week following the initial excision. While the patient did not exhibit symptoms of nerve compression, she reported experiencing swelling and pain at the surgical site postoperatively. The patient underwent surgical re-excision of the lesion, and the excised tissue was sent for histological examination. The subsequent histological analysis confirmed the diagnosis of a benign lipoma. The patient expressed satisfaction with the surgical revision, postoperative care, and outcomes, reporting high levels of contentment in pain relief, functional improvement, and cosmetic results.
Lipomas often remain asymptomatic for extended periods, only becoming a source of discomfort or concern once they increase in size or impact one's appearance. Although most lipomas are benign and pose little risk to overall health, certain malignant variants exist. Recurrence of lipoma is uncommon and typically suggests an incomplete initial excision. In anatomically complex regions like the hand or wrist, meticulous planning and preoperative imaging are essential to prevent compression, exclude malignancy, and preserve function.
女性，58岁。
手术切除不完全后复发性良性脂肪瘤。
不适、美学不满意。
手术翻修 - 切除 - 探查并摘除脂肪瘤。
整形外科（手外科）。
不寻常的临床表现及病程。
脂肪瘤是一种通常无痛的肿瘤，由间充质组织来源的脂肪细胞组成。它出现在身体有脂肪细胞的部位，呈局限性生长。其在手部的发病率相对较低（1% - 4.9%）。尽管大多数脂肪瘤是良性的且通常无症状，但脂肪瘤的位置可导致神经压迫症状。我们报告一例手腕部脂肪瘤不完全切除后不寻常复发的病例。
一名58岁女性，手腕掌侧有一个大的柔软肿块，在初次切除后的第一周复发。虽然患者未表现出神经压迫症状，但她报告术后手术部位出现肿胀和疼痛。患者接受了病变的再次手术切除，切除的组织送去做组织学检查。随后的组织学分析证实为良性脂肪瘤。患者对手术翻修、术后护理及结果表示满意，称在疼痛缓解、功能改善和美容效果方面都非常满意。
脂肪瘤通常长时间无症状，只有在增大或影响外观时才会成为不适或担忧的来源。虽然大多数脂肪瘤是良性的，对整体健康风险较小，但存在某些恶性变体。脂肪瘤复发并不常见，通常提示初次切除不完全。在手部或手腕等解剖结构复杂的区域，精心规划和术前影像学检查对于预防压迫、排除恶性肿瘤及保留功能至关重要。
