Giant Intermuscular Thenar Lipoma: A Case Report and Literature Review

Abstract

Lipoma is the most common benign tumour in hand. Lipoma in hand of size more than 5 cm is classified as Giant Lipoma. Lipoma of larger sizes is rare in hand because of accessibility and lesser subcutaneous tissues. Large lipoma interferes in the hand functions. Lipoma in dominant hand is usually noted early and gets operated. This case is of 65 year old female patient who reported with the swelling in right hand for past 25 years. The size of the lipoma was big and asymptomatic till the presentation. The swelling was investigated and surgically removed which was diagnosed histopatholoically as Intermuscular Thenar Lipoma .

A Case of Intramuscular Lipoma of Thenar Eminence With a Short Review of Published Hand Lipoma Case Reports

“…While the benign version has a simple anomaly of inversion or translocation, the malignant tumours have a giant chromosome or a supernumerary ring [ 28 ]. Consequently, an MRI and needle biopsy followed by cytogenetic/histological testing is useful in such cases [ 29 ]. Understandably, a referral to the national sarcoma service is warranted in proven malignant cases after needle biopsy/excision [ 5 , 30 ].…”

“…Apart from the recurrence that can occur due to incomplete removal, hematoma formation has also been described post-surgery due to the large dead space being left [ 32 ]. This requires close follow-up in patients on antiplatelet and blood thinning medications [ 29 ]. Lipomas in the hand have a very real potential to cause neurological compromise, especially of the thumb due to compression of the radial digital nerve, more so by giant lipomas measuring over 5 cm in size [ 12 , 33 ].…”

“…Notably, mid-palmar lipomas show a 45% incidence of neural compromise, which is more than three times that in thenar lipomas. The largest thenar lipoma among the reported studies was 8.1 × 4.9 × 6.7 cm [ 29 ].…”