A giant hand lipoma as a rare cause of secondary carpal tunnel syndrome - A case report

Abstract

Highlights Space-occupying lesions like lipoma are a rare cause of secondary compression neuropathies of the upper extremity. Atypical symptomatology should raise suspicion of local causes and regular work-up should be extended. Images studies leads to successful diagnosis and guidance of the best surgical treatment. Monobloc resection is still the best treatment to reduce the risk of iatrogenic lesions and disease recurrence.

A rare case of nerve compression caused by a connected lipoma of the wrist

“…Symptomless small masses assumed to be simple lipomas can be observed. In giant lipomas, defined as larger than 5 cm in diameter [4,5], excisional biopsy is recommended because these lesions have a higher chance of being liposarcoma and the symptoms mentioned above may be more common due to the higher likelihood of compression neuropathy [5,8,10]. Monobloc resection with careful dissection is the treatment of choice to prevent recurrence and iatrogenic injuries, considering the intricate anatomy of the hand.…”

Large Angiolipoma of the Hand as a Cause for Carpal Tunnel Syndrome

“…This case is the first report of an angiolipoma as a cause of carpal tunnel syndrome. Barreira et al 9 described the recurrence of carpal tunnel syndrome in a patient because of a giant lipoma that developed in the hand within 6 months of the primary surgery. Also, Chen et al 10 retrospectively reviewed space-occupying lesions as a cause for carpal tunnel syndrome and noted only 3 lipomas as a cause in 779 patients who underwent the procedure.…”

Secondary carpal tunnel syndrome caused by space-occupying lesion-lipoma

“…(ENMG) can be useful to support this diagnosis 5,6 . But ENMG is not required for the diagnosis of CTS in the presence of palpable mass 3,7,10 . In our case, we didn't need to ENMG for diagnosis of CTS and we diagnosed CTS with clinically.…”

“…Although they are in many parts of the body, they are rarely in the hand 2 . Lipomas are mostly asymptomatic, but if there is a nerve compression, they become symptomatic 3 .…”

“…Lipoma rarely causes carpal tunnel syndrome, only limited number of cases have been reported in the literature 3,6,10 . Chen reported 2 lipomas in 23 space occupying lesions out of 779 patients with carpal tunnel syndrome 10 .…”