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手部大鱼际和小鱼际肌处脂肪瘤,一种罕见表现;病例报告。

Lipoma in thenar and hypothenar eminence of the hand, a rare presentation; case report.

作者信息

Tiruneh Mandante Bogale, Alemayehu Dawit, Yeshaneh Diress, Dessalegn Megbar, Abiye Dagmawi, Ayana Birhanu

机构信息

Department of Surgery, School of medicine, Debre Markos University, 269, Ethiopia.

Department of Surgery, School of medicine, Debre Markos University, 269, Ethiopia.

出版信息

Int J Surg Case Rep. 2025 Jan;126:110835. doi: 10.1016/j.ijscr.2025.110835. Epub 2025 Jan 3.

DOI:10.1016/j.ijscr.2025.110835
PMID:39756234
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11758074/
Abstract

INTRODUCTION

Lipomas are benign tumors primarily composed of adipose tissue, typically found in subcutaneous or intramuscular sites across the body. While lipomas in the hand are uncommon, their occurrence in both thenar and hypothenar eminences is exceedingly rare.

CASE PRESENTATION

In this case, 65-year-old female admitted to hospital with a ten-year history of progressive swelling in the palmar aspect of her right hand, resulting in limited finger movement. up on physical examination, firm, non-tender, mobile mass on the thenar (6 cm x5cm) and hypothenar (8 cm x3cm) regions. Cytology examination showed adipose tissue fragment compromised of mature adipocytes within oily background confirming a diagnosis of palmar lipoma Surgical excision via a single medial incision was performed under regional anesthesia wrist block, successfully removing the multi-lobulated mass while preserving neurovascular structures and tendons. The patient had an uneventful recovery with excellent wound healing and restored finger mobility.

DISCUSSION

Lipomas is a benign tumor composed of adipose tissue that can appear anywhere on the body. It can occur in the subcutaneous layer or at intramuscular or intermuscular sites. A lipoma in the hand appears as a slow-growing, painless, and soft lumpLipomas in both thenar and hypothenar eminences are exceptionally rare, and diagnosis relies on a combination of clinical evaluation, ultrasound, and FNAC, particularly in resource-limited settings.

CONCLUSION

This case underscores the importance of considering lipomas in the differential diagnosis of hand masses and highlights the efficacy of surgical management even in resource-limited settings.

摘要

引言

脂肪瘤是主要由脂肪组织构成的良性肿瘤,通常见于全身的皮下或肌内部位。手部脂肪瘤并不常见,而在鱼际和小鱼际隆起处出现则极为罕见。

病例介绍

本病例中,一名65岁女性因右手掌侧进行性肿胀10年入院,导致手指活动受限。体格检查发现,鱼际(6厘米×5厘米)和小鱼际(8厘米×3厘米)区域有质地坚硬、无压痛、可活动的肿块。细胞学检查显示,在油性背景中有由成熟脂肪细胞组成的脂肪组织碎片,确诊为掌部脂肪瘤。在区域麻醉(腕部阻滞)下,通过单一内侧切口进行手术切除,成功切除多叶状肿块,同时保留神经血管结构和肌腱。患者恢复顺利,伤口愈合良好,手指活动恢复正常。

讨论

脂肪瘤是由脂肪组织构成的良性肿瘤,可出现在身体的任何部位。它可发生于皮下层或肌内或肌间部位。手部脂肪瘤表现为生长缓慢、无痛的柔软肿块。鱼际和小鱼际隆起处的脂肪瘤极为罕见,诊断依赖于临床评估、超声和细针穿刺抽吸活检(FNAC)相结合,在资源有限的环境中尤其如此。

结论

本病例强调了在手部肿块的鉴别诊断中考虑脂肪瘤的重要性,并突出了即使在资源有限的环境中手术治疗的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c54/11758074/6e07179e01c5/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c54/11758074/cc4c186adbaf/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c54/11758074/25cda1c942f7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c54/11758074/45f163d36985/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c54/11758074/16989b8bb094/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c54/11758074/6e07179e01c5/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c54/11758074/cc4c186adbaf/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c54/11758074/25cda1c942f7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c54/11758074/45f163d36985/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c54/11758074/16989b8bb094/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c54/11758074/6e07179e01c5/gr5.jpg

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