An exceptionally large giant lipoma of the hand

Abstract

Lipomas are benign tumours that consist of mature adipocytes. They are the commonest soft tissue tumours, most frequently seen in the trunk and proximal extremities. Lesions in the hand are uncommon, and giant lipomas of the hand, defined as greater than 5 cm in size, are particularly rare. We present a case of an exceptionally large giant lipoma of the hand, presenting as an extremely large inconvenient swelling of the palm in a 67-year-old woman. The diagnosis of lipoma was suggested via ultrasonography, and confirmed via MRI and histology. The lesion was successfully excised with no postoperative neurovascular deficit. The excised lesion measured 8×6×3 cm, one of the largest giant lipomas of the hand reported to date. When patients present with large lesions such as these a malignant cause must always be considered, and appropriate early imaging is essential when assessing these patients.

Clinical presentation, diagnostic approach, and treatment of hand lipomas: a review

“…Liposarcoma is the second most common soft tissue sarcoma (15). There are different subtypes of liposarcomas, including well-differentiated liposarcoma and myxoid liposarcoma (16). Generally, magnetic resonance imaging (MRI) and biopsy are used to rule out this diagnosis (2).…”

“…Generally, magnetic resonance imaging (MRI) and biopsy are used to rule out this diagnosis (2). On MRI, liposarcomas tend to appear more heterogenous, poorly encapsulated, and larger in size (16,17). Furthermore, liposarcoma may have thick fibrous septa, nodules, or areas of necrosis on T1-weighted sequences (10,15).…”

“…3). Patients generally seek treatment due to cosmetic disturbances or functional impairment (11,16). There is a low risk of a lipoma transforming into a liposarcoma (16).…”

“…Patients generally seek treatment due to cosmetic disturbances or functional impairment (11,16). There is a low risk of a lipoma transforming into a liposarcoma (16). Due to the high density of neurovascular structures in the hand, the risk of iatrogenic lesions is high (2).…”

Compressive Neuropathy of the Ulnar Nerve in the Hypothenar Region by Lipoma: Case Report

“…Rare cases developed with neurological manifestations, and all revealed resolution of the pain and motor symptoms when present. [18][19][20][21][22][23][24][25][26][27][28]…”