CC BY 4.0 · J Brachial Plex Peripher Nerve Inj 2021; 16(01): e10-e16
DOI: 10.1055/s-0041-1726087
Original Contribution

Lipomas as an Extremely Rare Cause for Brachial Plexus Compression: A Case Series and Systematic Review

1   Department of Neurosurgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
,
Yahya Ahmadipour
1   Department of Neurosurgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
,
Mehdi Chihi
1   Department of Neurosurgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
,
Thiemo F. Dinger
1   Department of Neurosurgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
,
Laurèl Rauschenbach
1   Department of Neurosurgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
,
Daniela Pierscianek
1   Department of Neurosurgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
,
Ramazan Jabbarli
1   Department of Neurosurgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
,
Ulrich Sure
1   Department of Neurosurgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
,
Karsten H. Wrede
1   Department of Neurosurgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
,
Anne-Kathrin Uerschels
1   Department of Neurosurgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
› Author Affiliations
Funding An IFORES grant (D/107-40960) to Oliver Gembruch from the University of Duisburg-Essen supported the research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Abstract

Introduction Brachial plexus lipomas are extremely rare benign tumors that may cause slow progression of neurological deficits leading to thoracic outlet syndrome. Up to now, surgery remains challenging. The aim of this study is to present our surgical treatment regime and long-term neurological outcome in three cases of giant brachial plexus lipomas and to show results of systematic review.

Patients and Methods Retrospective analysis of our database “peripheral nerve lesion” to identify patients suffering from brachial plexus lipomas between January 1, 2012, and December 31, 2019. Systematic review was performed for literature published until March 31, 2020, analyzing PubMed, Google Scholar, Scopus, and the Cochrane Collaboration Library independently by two authors.

Results Over the past years, three patients suffering from giant brachial plexus lipomas attended to our neurosurgical department. All patients underwent preoperative magnetic resonance imaging (MRI), ultrasound examinations, and electrophysiological testing. Tumors were removed microsurgically via anterior/posterior, supraclavicular/infraclavicular, and combined approaches. The patients were accessed postoperatively by MRI and clinical follow-up. Systematic review of the literature revealed 22 cases, which were analyzed in regard to demographics, surgical treatment, and neurological outcome.

Conclusion Brachial plexus lipomas are an extremely rare cause for brachial plexus compression. Total microsurgical removal with intraoperative electrophysiological monitoring is the treatment of choice with excellent long-term MRI and clinical outcome.

Authors' Contributions

O.G. contributed in writing the manuscript, acquisition of data, analysis and interpretation of data, study concept and design. Y.G. helped in revising the manuscript, analysis and interpretation of data. M.C. contributed in revising the manuscript, analysis and interpretation of data. T.F.D. helped in revising the manuscript, acquisition of data, analysis and interpretation of data. L.R. contributed in revising the manuscript, analysis and interpretation of data. D.P.in revising the manuscript, analysis and interpretation of data. R.J. in revising the manuscript, analysis and interpretation of data. U.S. in revising the manuscript, analysis and interpretation of data. K.H.W. in revising the manuscript, analysis and interpretation of data. A.-K.U. in writing the manuscript, acquisition of data, analysis and interpretation of data. All authors read and approved the final manuscript.




Publication History

Received: 02 May 2020

Accepted: 26 July 2020

Article published online:
13 April 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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