A rare case of posterior interosseous nerve palsy due to ganglion cyst arising from supinator muscle

Purohit, Shaligram; Prabhakar, Akil; Raj, Aditya; Marathe, Nandan; Shah, Swapneel

doi:10.1016/j.jcot.2020.01.012

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…Compression of the PIN can occur at different anatomical regions, as at the origin of the extensor carpi radialis brevis, at the arcade of Frohse, and the supinator's distal edge muscle [1,2]. However, entrapment or compression of the PIN can be caused by different benign pathologies such as the parosteal lipoma [1,3,8], intraneural lipoma [4], and a ganglion cyst [5].…”

Section: Discussionmentioning

confidence: 99%

“…The approach used for surgery should offer a wide exposure and a safe window to perform dissection and excision of the mass for the safety of the neural structures. We used the anterior approach for excising the mass, which was recommended in previous studies, as it offered better visualization and access to the lesion, and better use of the anterior approach for excising these lesions [5,8,10]. However, in their case report, Vikas et al used the posterior approach to access a parosteal bilobed lipoma, and they reported excellent visualization of PIN and its branches, which guarded against iatrogenic injury nerve during dissecting and excising the lesion [1].…”

Section: Discussionmentioning

confidence: 99%

“…Various conditions can cause the PIN entrapment, such as fractures or dislocations around the elbow, neoplasms (lipoma, schwannoma), ganglion cysts, the fibrous arcade of Frohse, and vascular aneurysms [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Posterior interosseous nerve entrapment by intramuscular lipoma arising from the supinator muscle - a case report

Refai

Elsherif

Khalifa

2021

Romanian Journal of Orthopaedic Surgery and Traumatology

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Background: Lipomas are benign, slow-growing tumors frequently subcutaneous and asymptomatic, intramuscular lipoma constituting a rare subtype. However, a lipoma occurring nearby the proximal radius may cause posterior interosseous nerve (PIN) entrapment. Case presentation: We described an uncommon case of a 45-year-old-man with a history of progressive, painless proximal right (dominant) forearm swelling for 4 months associated with PIN entrapment syndrome, presenting as fingers extension weakness. Intramuscular lipoma was observed in the supinator muscle in the magnetic resonance imaging (MRI). Lipoma surgical excision and release of the PIN through proximal forearm direct anterior approach was performed. Results: The histopathological examination confirmed the diagnosis of benign intramuscular lipoma. The follow-up of the patient showed full recovery within three months postoperatively. Discussion: Intramuscular lipoma is rare; however, it could originate from supinator muscle in the forearm, presenting with vague pain and could lead to compression of nearby neurovascular structures such as the PIN. Clinical evaluation and imaging studies, especially MRI, are crucial for diagnosis. If neural compression is evident, surgical resection is mandatory. Conclusion: Intramuscular lipoma entrapping PIN is rare and requires early clinical diagnosis confirmed by imaging and neurophysiological studies, surgical excision being the method of choice for optimum functional outcomes.

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