Distribution of intramuscular giant lipomas in the functional compartments of the forearm: a report of 12 cases

Abstract

Purpose The aim of this study was to investigate the distribution of intramuscular giant lipomas in the functional compartments of the forearm and to compare their clinical, radiological and histopathological features with those reported in the current literature.

Methods The study included 12 patients who were surgically treated for intramuscular lipomas > 5 cm in size located in the forearm that had been confirmed histopathologically between April 2006 and March 2017. Data about the patients with respect to age, sex, affected side, localisation of the lipomas in the forearm functional compartments, size, histopathological features and recurrence were collected. According to the clinical complaints, direct radiography and magnetic resonance imaging were applied.

Results The average diameter was 6.5 cm (range: 5.5–9 cm). All lipomas had a well-defined border. All the patients presented with soft-tissue masses that were painless in seven patients. Five patients had nerve compression symptoms. When the lipomas were classified according to the functional compartments of the forearm, six of them were located in the superficial volar compartment, two in the deep volar compartment, two in the deep dorsal compartment and two in the lateral compartment. All lipomas were surgically removed by marginal excision. None had complications or recurrence at a mean of 6.5 years follow-up (range: 1–12 years) after surgery.

Conclusions Intramuscular lipoma is a relatively uncommon tumour, especially in the forearm. Because of the proximity to the neurovascular structures in the forearm, excision of lipomas should be performed with care and include wide incisions. Additionally, knowing the anatomical features of the compartment where the lipoma is localised in the forearm is important in planning surgery to enable easier dissection of the lipoma and lessen the risk of damage to adjacent neurovascular structures.

Level of evidence Level 4

Zusammenfassung

Zweck Ziel dieser Studie war es, die Verteilung der intramuskulären Riesenlipome in den funktionellen Kompartimenten des Unterarms zu untersuchen und deren klinische, radiologische und histopathologische Eigenschaften mit denen der aktuellen Literatur zu vergleichen.

Methoden Die Studie umfasste 12 Patienten, die chirurgisch gegen intramuskuläre Lipome > 5 cm groß im Unterarm behandelt wurden, die zwischen April 2006 und März 2017 histopathologisch bestätigt wurden. Es wurden Daten über die Patienten in Bezug auf Alter, Geschlecht, betroffene Seite, Lokalisation der Lipome in den Funktionskammern des Unterarms, Größe, histopathologische Merkmale und Rezidiv erhoben. Nach den klinischen Beschwerden wurden Direktradiographie und Magnetresonanztomographie eingesetzt.

Ergebnisse Der durchschnittliche Durchmesser betrug 6,5 cm (Bereich: 5,5–9 cm). Alle Lipome hatten einen gut definierten Rand. Alle Patienten zeigten Weichteilmassen, die bei sieben Patienten schmerzfrei waren. Fünf Patienten hatten Symptome einer Nervenkompression. Bei der Klassifizierung der Lipome nach den funktionellen Abteilungen des Unterarms befanden sich sechs davon im oberflächlichen volaren Kompartiment, zwei im tiefen volaren Kompartiment, zwei im tiefen dorsalen Kompartiment und zwei im seitlichen Kompartiment. Alle Lipome wurden operativ durch marginale Exzision entfernt. Keiner hatte Komplikationen oder Rezidive bei durchschnittlich 6,5 Jahren Follow-up (Bereich: 1–12 Jahre) nach der Operation.

Schlussfolgerungen Das Intramuskuläre Lipom ist ein relativ seltener Tumor, insbesondere im Unterarm. Aufgrund der Nähe zu den neurovaskulären Strukturen im Unterarm sollte die Entfernung von Lipomen sorgfältig durchgeführt werden und breite Schnitte beinhalten. Darüber hinaus ist es wichtig, die anatomischen Merkmale des Kompartiments zu kennen, in dem das Lipom im Unterarm lokalisiert ist, um die Operation zu planen, eine leichtere Präparation des Lipoms zu ermöglichen und das Risiko einer Schädigung benachbarter neurovaskulärer Strukturen zu verringern.

Evidenzlevel Ebene 4

Schlüsselwörter

Tief angesiedelt - Lipom - Unterarm - intramuskulär - Riesen - Nervenkompression

Key words

Deep-seated - lipoma - forearm - intramuscular - giant - nerve compression

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