Table 1.
Lipomas of the Hand*
| Patient No. | Age | Sex | Location | Presenting Symptoms | Tissue Involvement | Tumor Size | Operative Approach | Follow-up | Recurerence | Note |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 52 | F | Dorsum of L hand, webspace of 2nd and 3rd metacarpals | N/A | Not fixed to overlying skin; fixed to extensor tendons of index and long fingers and dorsal interossei | N/A | Longitudinal incision, simple dissection, neurolysis, tenolysis, excision | 46 months | No | — |
| 2 | 50 | M | R long finger, middle phalanx, dorsal radial aspect | N/A | Extensor tendon of long finger; dorsal branch of radial digital nerve | 3.2 × 1.3 × 0.9 cm3 | Transverse oblique fusiform incision, complex dissection, neurolysis, tenolysis, excision | 108 months | No | — |
| 3 | 41 | M | R palm, between long and ring fingers | painless mass × 2 years | Radial digital nerve and artery of ring finger; ulnar digital nerve and artery of long finger | 3 × 1.5 × 1.5 cm3 | Modified Brunner incision, complex dissection, neurolysis, arteriolysis, excision | 56 months | No | Figure 1 |
| 4 | 58 | M | R index finger, proximal phalynx, radial aspect | painless mass × 2 weeks | Adherent to overlying skin; ulnar neurovascular bundle of index finger; dorsal surface of extensor tendon of index finger | 2.5 × 2.2 × 1.1 cm3 | Modified Brunner incision, complex dissection, arteriolysis, neurolysis, excision | 1 month | No | — |
| 5 | 63 | M | R palm, thenar eminence | Swelling, aching, weakness of R thumb × 2 months | Radial neurovascular bundle of thumb | 3 × 1.8 × 1.1 cm3 | Brunner incision, complex dissection, arteriolysis, neurolysis, excision | N/A | N/A | — |
| 6 | 72 | F | L palm, hypothenar eminence | Swelling, tenderness over ulnar border of L hand × 14 months | Ulnar nerve at bifurcation of motor and sensory branches; Guyon's canal | 4.5 × 2.5 × 1.2 cm3 | Resection of previous scar along ulnar border, complex dissection, neurolysis, excision | 26 months | No | History of previous attempted resection 1 month prior, Figure 3 |
| 7 | N/A | F | Dorsum of R hand, webspace of 1st and 2nd metacarpals | Large mass | Princeps pollicis artery; ulnar neurovascular bundle of thumb; radial neurovascular bundle of index finger | 6.5 × 4 × 4 cm3 | Longitudinal incision, complex dissection, arteriolysis, neurolysis, excision, placement of silastic drains × 2 | N/A | N/A | Closure with 2 silastic drains; Figure 2 |
| 8 | 58 | F | L palm, webspace of 1st and 2nd metacarpals, extending into carpal tunnel | Swelling, itching × 4 months | Radial neurovascular bundle of index finger; noninvasive pressure on ulnar nerve | 3.2 × 2.2 × 1 cm3 | Longitudinal incision on dorsum of hand + classic carpal tunnel incision, complex dissection, neurolysis, tenolysis, excision, decompression L carpal tunnel | 61 months | No | — |
| 9 | 55 | M | L forearm, deep to supinator | Unable to extend fingers or wrist × 3 months | Supinator; radial nerve | 5 × 3.5 × 2.5 cm3 | Transverse incision on dorsal wrist with exploration, curved incision on lateral aspect of elbow and forearm, complex dissection, neurolysis, excision | 12 months | No | — |
| 10 | 62 | F | Dorsum of R hand | Enlarging mass × 30 months | Superficial fascia | 2.2 × 1.1 × 0.6 cm3 | Fusiform incision, simple dissection, excision | 1 month | No | — |
| 11 | 57 | M | Distal volar aspect of L wrist | Progressively enlarging mass with discomfort × 2–3 years | Adherent to overlying skin and flexor retinaculum | 2.6 × 1.9 × 0.7 cm3 | Transverse incision, complex dissection, excision | 1 month | No | — |
| 12 | 71 | F | L thumb, proximal phalynx, palmar aspect | Pain at base of left thumb and wrist | 300° circumferential involvement of proximal phalynx; neurovascular bundle; flexor pollicis longus | 4 × 3 × 3 cm3 | Transverse incision, complex dissection, arteriolysis, neurolysis, tenolysis, excision | 3 months | No | — |
| 13 | 48 | M | R palm | Hand cramps, mass × 72 months, enlarging × 3 months | Adductor pollicis; opponens pollicis; ulnar neurovascular bundle of thumb; radial neurovascular bundle of index finger | 5.3 × 4 × 2 cm3 | Counter incisions on anterior and posterior surfaces of webspace between 1st and 2nd metacarpals extending into thenar eminence, complex dissection, extensive neurolysis, excision, placement of silastic drains × 2 | 1 month | No | Closure with 2 silastic drains |
*F, female; M, male; L, left; R, right; N/A, not availabale.