Giant Lipomas of the Hand. Our ExperienceArticle in several languages: English | español
Objective Giant lipomas are benign tumors larger than 5 cm in size that are very uncommun in the hand, with the extant literature limited to case reports and small case series. The aim of the present study is to describe our experience with giant lipomas at the level of the hand, reviewing the most important aspects in relation to their diagnosis and treatment.
Material and Methods We present 6 patients treated in our service with giant lipomas of the hand between 2007 and 2015. Four cases only presented difficulty in grasping and mobilizing the hand due to the large size of the lipoma. Two cases were accompanied by a clinical feature of compression of the median nerve in relation to its location within the carpal tunnel.
Results All patients underwent surgery, and a complete excision of the lipoma was performed. The functional results have been satisfactory in all cases.
Conclusions Giant lipomas of the hand are infrequent tumors of slow growth, generally asymptomatic, although they can cause a compressive pathology due to the great size that they reach. Magnetic resonance imaging is an especially useful test to locate and accurately determine the size of the lesion in view of its surgical excision. After surgery, it is important to make a differential diagnosis with low-grade liposarcomas through an anatomopathological study, since both, macroscopically, have similar characteristics.
Received: 08 January 2020
Accepted: 07 July 2020
24 September 2020 (online)
© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
- 1 Fnini S, Hassoune J, Garche A, Rahmi M, Largab A. Lipome géant de la main : présentation d'un cas clinique et revue de la littérature. Chir Main 2010; 29 (01) 44-47
- 2 Chatterton BD, Moores TS, Datta P, Smith KD. An exceptionally large giant lipoma of the hand. BMJ Case Rep 2013; 2013: bcr2013200206 DOI: 10.1136/bcr-2013-200206.
- 3 Fazilleau F, Williams T, Richou J, Sauleau V, Le Nen D. Median nerve compression in carpal tunnel caused by a giant lipoma. Case Rep Orthop 2014; 2014: 654934
- 4 Cribb GL, Cool WP, Ford DJ, Mangham DC. Giant lipomatous tumours of the hand and forearm. J Hand Surg [Br] 2005; 30 (05) 509-512
- 5 De Smet L, Bande S, Fabry G. Giant lipoma of the deep palmar space, mimicking persistent carpal tunnel syndrome. Acta Orthop Belg 1994; 60 (03) 334-335
- 6 Ohguri T, Aoki T, Hisaoka M. et al. Differential diagnosis of benign peripheral lipoma from well-differentiated liposarcoma on MR imaging: is comparison of margins and internal characteristics useful?. AJR Am J Roentgenol 2003; 180 (06) 1689-1694
- 7 Capelastegui A, Astigarraga E, Fernandez-Canton G, Saralegui I, Larena JA, Merino A. Masses and pseudomasses of the hand and wrist: MR findings in 134 cases. Skeletal Radiol 1999; 28 (09) 498-507
- 8 Fraga J, García-Elías M, Lluch A. Lipomas Gigantes da Eminência Tenar. Rev Iberoam Cir Mano 2013; 41 (01) 37-39
- 9 Santos-Maraver MT, Collado-Torres F, De la Torre-Solís F, Roson Mendez-Trelles JJ. Lipomas de la mano: cuatro nuevos casos. Revisión bibliográfica. Rev Orthop Traum. 1994; 38 (04) 297-301
- 10 Ramirez-Montaño L, Lopez RP, Ortiz NS. Giant lipoma of the third finger of the hand. Springerplus 2013; 2 (01) 164
- 11 Higgs PE, Young VL, Schuster R, Weeks PM. Giant lipomas of the hand and forearm. South Med J 1993; 86 (08) 887-890
- 12 Leffert RD. Lipomas of the upper extremity. J Bone Joint Surg Am 1972; 54 (06) 1262-1266
- 13 Babins DM, Lubahn JD. Palmar lipomas associated with compression of the median nerve. J Bone Joint Surg Am 1994; 76 (09) 1360-1362
- 14 Jalan D, Garg B, Marimuthu K, Kotwal P. Giant lipoma: an unusual cause of carpal tunnel syndrome. Pan Afr Med J 2011; 9: 29
- 15 Grivas TB, Psarakis SA, Kaspiris A. et al. Giant lipoma of the thenar-case study and contemporary approach to its aetiopathogenicity. Hand (NewYork) 2009; 4: 173-176
- 16 Irisarri C. Tumores de partes blandas en la mano. Rev Iberoam Cir Mano 1995; 49 (22) 23-33
- 17 Mota FP, Fahandezh-Saddi H, Hualda AL. Lipoma gigante bilobular en la mano: caso clínico y revisión de la literatura. Rev. Iberam. Cir. Mano 2011; 39 (01) 70-74
- 18 Nadar MM, Bartoli CR, Kasdan ML. Lipomas of the hand: a review and 13 patient case series. Eplasty 2010; 10: e66
- 19 Allen B, Rader C, Babigian A. Giant lipomas of the upper extremity. Can J Plast Surg 2007; 15 (03) 141-144
- 20 Johnson CJ, Pynsent PB, Grimer RJ. Clinical features of soft tissue sarcomas. Ann R Coll Surg Engl 2001; 83 (03) 203-205
- 21 Kooby DA, Antonescu CR, Brennan MF, Singer S. Atypical lipomatous tumor/well-differentiated liposarcoma of the extremity and trunk wall: importance of histological subtype with treatment recommendations. Ann Surg Oncol 2004; 11 (01) 78-84
- 22 Laurino L, Furlanetto A, Orvieto E, Dei Tos AP. Well-differentiated liposarcoma (atypical lipomatous tumors). Semin Diagn Pathol 2001; 18 (04) 258-262