Intraneural Posterior Interosseous Nerve Lipoma with Complete Paralysis: Case Report and Review of the Literature

Abstract

An intraneural posterior interosseous nerve (PIN) lipoma is a rare entity consisting of two types and only two previously reported cases. Treatment involves total excision for the well-encapsulated “true intraneural lipomas” type and subtotal resection for the other type, fibrolipomatous hamartomas of the nerve. We present the management and surgical treatment of a case that illustrates a variation of the traditional posterolateral surgical approach for the complete excision of an intraneural PIN lipoma—contrary to the more commonly used anterior approach in literature—along with a literature review of intraneural PIN lipomas.

Forearm Lipoma Causing PIN Compression: Literature Review and Meta-Analysis of Predictors for Motor Recovery

“…After duplicates were consolidated and articles screened for relevancy, 30 articles comprising 34 patients met inclusion criteria and were included in the analysis (Supplementary Table 1). 3,5-35 Studies comprised of case series and reports dating from 1953 to 2019. Each study included 1 to 4 patients, 31 of which described 1 patient.…”

The “Texas Longhorn” Syndrome: A Case of Posterior Interosseous Nerve Palsy With Noteworthy Observations

“…There are several case reports of proximal radio-ulnar ganglion lesions involving the PIN with excellent recovery following excision [9], of intraneural PIN lipomas [10], isolated case reports of PIN schwannomas [11], neuralgic amyotrophy presenting as an isolated PIN palsy [12], and rheumatoid arthritis with synovial invasion [13].…”

The Unusual Nerve Compression Seconder to the Intramuscular Lipoma: A Case Report

“…The optimal surgical approach can vary depending on the lipoma's anatomical relation and the distribution of the adjacent peripheral nerves (10). Patel AP et al reported that the anterior approach is the most frequent, and it is shown to have better outcomes (10). Therefore, the anterior surgical approach was performed through the forearm's flexor compartment between the brachioradialis and brachialis muscles in order to achieve optimal recovery and save the branches of the adjacent peripheral nerves.…”