Endoscopically Assisted Myectomy for Intramuscular Lipoma of Pronator Quadratus

Abstract

Intramuscular lipoma is usually growing infiltratively and can affect any muscle, although the proximal muscles of the extremities are mostly commonly involved. This lesion can occur in the pronator quadratus. Because of muscle is small and deep seated, the intramuscular lipoma usually involves the whole muscle and even has an extramuscular component before it presents clinically. In this Technical Note, we report the technique of endoscopically assisted myectomy of the pronator quadratus for infiltrating intramuscular lipoma of the muscle. This has the advantage of minimally invasive surgery of minimal soft tissue dissection and fewer soft tissue complications.

Endoscopically Assisted Resection of Intramuscular Lipoma of the Soleus

“…I ntramuscular lipoma is a rare soft-tissue tumor with an overall incidence of less than 1% of all lipomas. [1][2][3][4] It primarily occurs in the trunk and proximal parts of the upper and lower extremities. 2 There are 2 types of intramuscular lipoma: infiltrating (83%) and well circumscribed (17%).…”

“…[1][2][3][4] It primarily occurs in the trunk and proximal parts of the upper and lower extremities. 2 There are 2 types of intramuscular lipoma: infiltrating (83%) and well circumscribed (17%). 2 Surgical excision is the treatment of choice when the patient is symptomatic or for cosmetic purposes.…”

“…2 There are 2 types of intramuscular lipoma: infiltrating (83%) and well circumscribed (17%). 2 Surgical excision is the treatment of choice when the patient is symptomatic or for cosmetic purposes. 1,2 Generally accepted factors that favor surgical resection include size more than 5 cm, deep-seated tumors of the proximal lower extremities, infiltrative growth, or recurrence despite benign histology after resection.…”

“…2 Surgical excision is the treatment of choice when the patient is symptomatic or for cosmetic purposes. 1,2 Generally accepted factors that favor surgical resection include size more than 5 cm, deep-seated tumors of the proximal lower extremities, infiltrative growth, or recurrence despite benign histology after resection. 3 Open resection with marginal excision of the well-circumscribed tumor and wide excision of the infiltrative tumor is the classic surgical approach.…”

“…3 Open resection with marginal excision of the well-circumscribed tumor and wide excision of the infiltrative tumor is the classic surgical approach. 2,5 For small and deep-seated muscle, the intramuscular lipoma usually involves the whole muscle and even has an extramuscular component before it presents clinically. 2 In this case, myectomy can be considered.…”