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      • Record: found
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      Peripheral nerve lipoma: Case report of an intraneural lipoma of the median nerve and literature review

      case-report

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          Abstract

          Adipose lesions rarely affect the peripheral nerves. This can occur in two different ways: Direct compression by an extraneural lipoma, or by a lipoma originated from the adipose cells located inside the nerve. Since its first description, many terms have been used in the literature to mention intraneural lipomatous lesions. In this article, the authors report a case of a 62-year-old female who presented with an intraneural median nerve lipoma and review the literature concerning the classification of adipose lesions of the nerve, radiological diagnosis and treatment.

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          Size, site and clinical incidence of lipoma. Factors in the differential diagnosis of lipoma and sarcoma.

          A. Rydholm, Alfred Berg (1983)
          All 428 patients who had a non-visceral lipoma histopathologically diagnosed during 1 year in a defined population (0.74 million inhabitants) were analysed retrospectively as regards the age, duration of symptoms, size, site (location and depth) and multiplicity of the lipomas. Solitary subcutaneous lipomas were uncommon in the hand, thigh, lower leg and foot, and four-fifths of them (264/338) were smaller than 5 cm. Multiple subcutaneous lipomas were found in 61 patients, most of them young males. Subfascial lipomas, with a mean size (6 cm) double that of solitary subcutaneous lipomas, were found in 13 patients. A subgroup of 192 lipomas (153 patients) was reexamined histologically and the tumours were classified as either simple lipoma or angiolipoma. Angiolipomas were significantly more common in patients with multiple lipomas. To assess the reliability of a clinical diagnosis of lipoma as well as the proportion of clinically diagnosed lipomas not verified by histology, the records of patients seen in one department of surgery and in one health care centre were examined. Based on these data, the annual clinical incidence of lipoma (number of patients consulting a doctor for a lipoma, even if not histologically verified) was estimated to be 1/1000. When the data for solitary lipomas were compared to those for soft-tissue sarcoma, it was found that patient age and duration of symptoms were of minor value in the clinical differential diagnosis. However, if a tumour were (a) larger than 5 cm, irrespective of depth and location, (b) located in the thigh, irrespective of depth and size, or (c) deep, irrespective of location and size, it was more likely to be a sarcoma.(ABSTRACT TRUNCATED AT 250 WORDS)
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            A series of 146 peripheral non-neural sheath nerve tumors: 30-year experience at Louisiana State University Health Sciences Center.

            H. Kim, G Moes, Robert Tiel … (2005)
            This is a retrospective review of 146 surgically treated benign and malignant peripheral non-neural sheath tumors (PNNSTs). Tumor classifications with patient numbers, locations of benign PNNSTs, and surgical techniques and adjunctive treatments are presented. The results of a literature review regarding tumor frequencies are presented. One hundred forty-six patients with 111 benign and 35 malignant PNNSTs were treated between 1969 and 1999 at the Louisiana State University Health Sciences Center (LSUHSC). The benign tumors included 33 ganglion cysts, 16 cases of localized hypertrophic neuropathy, 12 lipomas, 12 tumors of vascular origin, and 11 desmoid tumors. There were four each of lipofibrohamartomas, myositis ossificans, osteochondromas, and ganglioneuromas; two each of meningiomas, cystic hygromas, myoblastoma or granular cell tumors, triton tumors, and lymphangiomas; and one epidermoid cyst. The locations of benign PNNSTs were the following: 33 in the brachial plexus region, 39 in an upper extremity, one in the pelvic plexus, and 38 in a lower extremity. The malignant PNNSTs included 35 surgically treated carcinomas, 15 of which originated in the breast and nine in the lung. There were two melanomas metastatic to nerve and one tumor each that had metastasized from the bladder, rectum, skin, head and neck, and thyroid, and from a primary Ewing sarcoma. There was a single lymphoma that had metastasized to the radial nerve and one chordoma and one osteosarcoma, each of which had metastasized to the brachial plexus. There were more benign PNNSTs than malignant ones. Benign tumors were relatively equally distributed in the brachial plexus region and upper and lower extremities, with the exception of the pelvic plexus, which had only one tumor.
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              Masses and pseudomasses of the hand and wrist: MR findings in 134 cases.

              I Saralegui, G Canton, A Merino-Trigo … (1999)
              To assess the utility of magnetic resonance imaging (MRI) in the investigation of palpable masses in the hand or wrist. DESIGN AND PATIENTS. We retrospectively reviewed the MRI examinations and case records of 134 patients referred because of a palpable mass in the hand or wrist. MRI was performed on a 1.0 T magnet using an extremity coil. Intravenous gadolinium-DTPA was injected when considered appropriate. MRI demonstrated the cause of the palpable mass in 126 cases (94.02%). Soft tissue neoplasms were found in 34 cases (25.37%). The majority were benign and included giant cell tumours of tendon sheath, lipomas and hemangiomas and had a characteristic appearance. There were three malignant tumours (myxoid liposarcoma, malignant fibroushistiocytoma and rhabdomyosarcoma). Ganglia were found in 36 cases (26.86%) and non-tumour tendon pathology in 31 cases (23.13%). Less common causes included articular diseases (5.97%) and anatomical variants (4.47%). No focal lesion was present in 8 cases (5.97%). In conclusion, MRI is an accurate diagnostic technique in patients who present with a palpable mass of the hand and wrist.
              Article 0 comments Cited 20 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Asian J Neurosurg
                Journal ID (iso-abbrev): Asian J Neurosurg
                Journal ID (publisher-id): AJNS
                Title: Asian Journal of Neurosurgery
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 1793-5482
                ISSN (Electronic): 2248-9614
                Publication date (Print): Oct-Dec 2016
                Volume: 11
                Issue: 4
                Page: 458
                Affiliations
                [1]Department of Neurosurgery, Hospital São José - Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil
                [1 ]Department of Neurosurgery, Hospital Cristo Redentor, Porto Alegre, RS, Brazil
                Author notes
                Address for correspondence: Dr. Alisson Roberto Teles, Hospital São José -Santa Casa de Porto Alegre, Av. Independencia, 155, CEP: 90035-074, Porto Alegre, RS, Brazil. E-mail: alisson.r.teles@ 123456gmail.com
                Article
                Publisher ID: AJNS-11-458b
                DOI: 10.4103/1793-5482.181118
                PMC ID: 4974996
                SO-VID: bd038af8-2cc9-4ff1-9449-6a8ac731e381
                Copyright © Copyright: © Asian Journal of Neurosurgery
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Surgery
                Keywords: carpal tunnel syndrome,lipoma,median nerve,peripheral nerves
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: carpal tunnel syndrome, lipoma, median nerve, peripheral nerves

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