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Carpal tunnel lipoma

Case contributed by Mauricio Macagnan
Diagnosis almost certain

Presentation

Paresthesia of the hand.

Patient Data

Age: 45 years
Gender: Female
mri

Expansive lesion located on the wrist, on the medial side along the ulnar neurovascular bundle extending from the base level of the metacarpals to the proximal third of the ulna diaphysis. The lesion is superficial to the adductor muscle of the little finger in its distal aspect, extending proximally within the carpal tunnel to the level of the distal third of the ulna, between the tendons of the superficial flexor of the fingers and the deep tendon.

The lesion has a fat-like signal intensity and has a thin fibrous capsule with an appearance suggestive of lesion of lipomatous origin.

Case Discussion

A lipoma is a tumor of adipose cell origin, benign and relatively frequent. However, it is rarely located in the hand representing 1-3.8% of benign tumors in the hand. A lipoma of the hand that causes carpal tunnel syndrome by the median nerve compression is extremely rare.

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