Summary
This paper presents two women who visited the phlebology surgery in the opinion that
varices would be responsible for their symptoms. Patient 1 complained of nocturnal
pain that radiated from the posterior surface of the left thigh to the anterior and
lateral surfaces of the knee and lateral aspect of the calf. This pain occurred whenever
she changed position. Patient 2 felt numbness in her right foot and an annoying burning
sensation in her right heel. She was known to have lumbar discopathy and stenosis
of the spinal canal which however, according to neurological diagnosis, could not
explain the symptoms. On clinical examination neither had visible nor palpable varices,
nor any recognisable dermal signs of venous hypertension. However, it was conspicuous
that the left foot of patient 1 barely reached the floor when she was sitting down.
In patient 2 the circumference of the right calf was increased by 2 cm.
In both cases a coarse, circumscribed thickening was palpable deep in the posterior
surface of the thigh (patient 1) and the proximal calf (patient 2). This was responsible
for the asymmetrical posture in sitting of patient 1. Doppler/duplex sonography did
not reveal any pathological findings in either patient. Thanks to MRI scans the cause
in both cases was found to be a subfascial tumour that was displacing the musculature,
thus compressing nervous structures; once in the thigh (patient 1: 600 g), once in
the calf (patient 2: 200 g). In both women the symptoms disappeared after surgical
extirpation of the clinically and histologically verified lipomas.
Zusammenfassung
Es werden zwei Patientinnen vorgestellt, die sich in der phlebologischen Sprechstunde
meldeten in der Meinung, dass Varizen für ihre Beschwerden verantwortlich seien. Ihre
Symptomatik ist aus phlebologischer Sicht atypisch und lässt ursächlich an eine peripher-neuro
logische Kompressionssymptomatik denken. Der Venenstatus ist unauffällig. Als Ursache
kann in beiden Fällen ein subfaszial die Muskulatur verdrängendes Lipom, das neurogene
Strukturen komprimiert, gefunden werden: einmal im Oberschenkel (600 g), einmal in
der Wade (200 g).
Keywords
Leg discomfort - varicose vein - neural compression - giant lipoma - thigh - calf
Schlüsselwörter
Beinbeschwerden - Varizen - neurogene Kompression - subfasziale Lipome - Oberschenkel
- Wade
