CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2020; 39(01): 049-053
DOI: 10.1055/s-0038-1623517
Case Report | Relato de Caso
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Neuropatia compressiva do nervo ulnar em região hipotenar por lipoma: relato de caso

Artikel in mehreren Sprachen: English | português
1   Department of Neurosurgery, Vila da Serra Hospital, Belo Horizonte, Minas Gerais, MG, Brazil
3   Hospital Aroldo Tourinho, Montes Claros, Minas Gerais, MG, Brazil
,
Henrique Nunes Pereira Oliva
2   Faculdade Pitágoras de Montes Claros, Montes Claros, Minas Gerais, MG, Brazil
,
Bruno Lopes Nunes
3   Hospital Aroldo Tourinho, Montes Claros, Minas Gerais, MG, Brazil
› Institutsangaben
Weitere Informationen

Publikationsverlauf

12. September 2017

04. Dezember 2017

Publikationsdatum:
28. Februar 2018 (online)

Resumo

Lipomas são tumores bem definidos, de tecido adiposo, presentes no tronco ou nas extremidades, e que ocorrem em pacientes adultos. Esses tumores geralmente se desenvolvem sem dor e de forma insidiosa, podendo, no entanto, comprimir estruturas adjacentes. Este trabalho objetiva descrever o caso de uma paciente do sexo feminino, de 68 anos, com lipoma gigante localizado na face hipotenar, com manifestação de compressão dos nervos digitais palmares comuns, do nervo ulnar, e do músculo abdutor do V dedo. Como sintoma, ela apresentava quadro de dor moderada na face hipotenar, sem sinal de Tinel, e sem alterações da motricidade ou sensibilidade dos dígitos inervados pelo nervo ulnar. Os lipomas podem apresentar variada gama de características histológicas, e o diagnóstico diferencial pode incluir tumores malignos. O exame de imagem pode auxiliar no diagnóstico, o qual é confirmado por meio de estudo histopatológico. Para o presente caso, conforme preconizado na literatura, foi realizado um procedimento cirúrgico para a ressecção do tumor, que resultou no controle dos sintomas.

 
  • References

  • 1 Errani C, Cocchi S, Ali N. , et al. Recurrence after marginal excision for atypical lipomatous tumors versus lipomas of the extremities. Orthopedics 2016; 39 (04) e610-e614
  • 2 Elbardouni A, Kharmaz M, Salah Berrada M, Mahfoud M, Elyaacoubi M. Well-circumscribed deep-seated lipomas of the upper extremity. A report of 13 cases. Orthop Traumatol Surg Res 2011; 97 (02) 152-158
  • 3 Ramos-Pascua LR, Guerra-Álvarez OA, Sánchez-Herráez S, Izquierdo-García FM, Maderuelo-Fernández JA. [Intramuscular lipomas: Large and deep benign lumps not to underestimated. Review of a series of 51 cases]. Rev Esp Cir Ortop Traumatol 2013; 57 (06) 391-397
  • 4 Jones AP, Lewis CJ, Dildey P, Hide G, Ragbir M. Lipoma or liposarcoma? A cautionary case report. J Plast Reconstr Aesthet Surg 2012; 65 (01) e11-e14
  • 5 Fisher SB, Baxter KJ, Staley III CA. , et al. The General Surgeon's quandary: atypical lipomatous tumor vs lipoma, who needs a surgical oncologist?. J Am Coll Surg 2013; 217 (05) 881-888
  • 6 Dalal KM, Antonescu CR, Singer S. Diagnosis and management of lipomatous tumors. J Surg Oncol 2008; 97 (04) 298-313
  • 7 Kito M, Yoshimura Y, Isobe K. , et al. Clinical outcome of deep-seated atypical lipomatous tumor of the extremities with median-term follow-up study. Eur J Surg Oncol 2015; 41 (03) 400-406 (EJSO)
  • 8 Kindblom LG, Angervall L, Stener B, Wickbom I. Intermuscular and intramuscular lipomas and hibernomas. A clinical, roentgenologic, histologic, and prognostic study of 46 cases. Cancer 1974; 33 (03) 754-762
  • 9 Cappabianca S, Colella G, Pezzullo MG. , et al. Lipomatous lesions of the head and neck region: imaging findings in comparison with histological type. Radiol Med (Torino) 2008; 113 (05) 758-770
  • 10 Inampudi P, Jacobson JA, Fessell DP. , et al. Soft-tissue lipomas: accuracy of sonography in diagnosis with pathologic correlation. Radiology 2004; 233 (03) 763-767
  • 11 Murphey MD, Carroll JF, Flemming DJ, Pope TL, Gannon FH, Kransdorf MJ. From the archives of the AFIP: benign musculoskeletal lipomatous lesions. Radiographics 2004; 24 (05) 1433-1466
  • 12 Henderson MM, Neumeister MW, Bueno Jr RA. Hand tumors: I. skin and soft-tissue tumors of the hand. Plast Reconstr Surg 2014; 133 (02) 154e-164e
  • 13 Weisstein JS, Trumble TE, Budoff JE. Benign and malignant bone tumors. Hand Surgery Updates IV. American Society for Surgery of the Hand, Rosemont, USA; 2007
  • 14 Adams EL, Yoder EM, Kasdan ML. Giant cell tumor of the tendon sheath: experience with 65 cases. Eplasty, v. 12, 2012
  • 15 Nahra ME, Bucchieri JS. Ganglion cysts and other tumor related conditions of the hand and wrist. Hand Clin 2004; 20 (03) 249-260 , v
  • 16 Forthman CL, Blazar PE. Nerve tumors of the hand and upper extremity. Hand Clin 2004; 20 (03) 233-242 , v
  • 17 Magalhães MJS, Fujioka AJ, Chaves RB. Schwannoma como etiologia de síndrome do túnel do carpo – relato de caso. Arq Bras Neurocir 2015; 34 (04) 309-312
  • 18 Rodriguez JM, Phalen GS. Lipomas in the hand and wrist; diagnosis and treatment. Cleve Clin Q 1970; 37 (04) 201-205
  • 19 Ceballos JIG, Wylock P. Hand palm and finger lipomas: four case reports and review of the literature. Eur J Plast Surg 2005; 28 (03) 243-246
  • 20 Kamath J, Kamath R, Bhardwaj P, Sharma C. A giant lipoma in the hand-report of a rare case. J Health Allied Sci 2006; 5 (01) 1-6
  • 21 Mohan L, Semoes J. Thenar intramuscular lipoma: an unusual case. Internet J Surg 2008; 17 (02) 1-3
  • 22 Nadar MM, Bartoli CR, Kasdan ML. Lipomas of the hand: a review and 13 patient case series. Eplasty 2010; 10: e66
  • 23 Pagonis T, Givissis P, Christodoulou A. Complications arising from a misdiagnosed giant lipoma of the hand and palm: a case report. J Med Case Reports 2011; 5 (01) 552
  • 24 Chatterton BD, Moores TS, Datta P, Smith KD. An exceptionally large giant lipoma of the hand. BMJ Case Rep 2013; 2013: bcr2013200206
  • 25 Ramirez-Montaño L, Lopez RP, Ortiz NS. Giant lipoma of the third finger of the hand. Springerplus 2013; 2 (01) 164
  • 26 Radivojcevic UM, Ilic M, Vulovic D. Giant hand lipoma-Case report of a rare localization of a common type of tumor. Sanamed 2016; 11 (02) 141-144
  • 27 Schmidt I. Giant Lipoma of the Thenar leading to Entrapment of All Peripheral Long Finger Branches of the Median Nerve: Case Report. JSM Clin Case Rep 2017; 5 (01) 1125
  • 28 Ribeiro G, Salgueiro M, Andrade M, Fernandes VS. Giant palmar lipoma - an unusual cause of carpal tunnel syndrome. Rev Bras Ortop 2017; 52 (05) 612-615