Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2023; 11(3): 684-691
Published online Jan 26, 2023. doi: 10.12998/wjcc.v11.i3.684
Recurrent intramuscular lipoma at extensor pollicis brevis: A case report
Je Yeon Byeon, Yong Seon Hwang, Ji Hye Lee, Hwan Jun Choi
Je Yeon Byeon, Yong Seon Hwang, Hwan Jun Choi, Plastic and Reconstructive Surgery, Soonchunhyang University Hospital, Cheonan-si 31151, South Korea
Ji Hye Lee, Department of Pathology, Soonchunhyang University Hospital, Cheonan-si 31151, South Korea
Author contributions: Byeon JY and Hwang YS contributed to manuscript writing and editing, and data collection; Lee JH contributed to histological examination of specimen; Choi HJ contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016). The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hwan Jun Choi, MD, PhD, Professor, Surgeon, Plastic and Reconstructive Surgery, Soonchunhyang University Hospital, No. 31 Sooncheonhyang 6-Gil, Dongnam-gu, Cheonan-si 31151, South Korea. iprskorea@gmail.com
Received: November 1, 2022
Peer-review started: November 1, 2022
First decision: December 13, 2022
Revised: December 14, 2022
Accepted: January 9, 2023
Article in press: January 9, 2023
Published online: January 26, 2023
Processing time: 86 Days and 2.8 Hours
Abstract
BACKGROUND

This report describes and discusses recurrent intramuscular lipoma (IML) of the extensor pollicis brevis (EPB). An IML usually occurs in a large muscle of the limb or torso. Recurrence of IML is rare. Recurrent IMLs, especially those with unclear boundaries, necessitate complete excision. Several cases of IML in the hand have been reported. However, recurrent IML appearing along the muscle and tendon of EPB on wrist and forearm has not been reported yet.

CASE SUMMARY

In this report, the authors describe clinical and histopathological features of recurrent IML at EPB. A 42-year-old Asian woman presented with a slow-growing lump in her right forearm and wrist area six months ago. The patient had a history of surgery for a lipoma of the right forearm one year ago with a scar of 6 cm on the right forearm. magnetic resonance imaging confirmed that the lipomatous mass, which had attenuation similar to subcutaneous fat, had invaded the muscle layer of EPB. Excision and biopsy were performed under general anesthesia. On histological examination, it was identified as an IML showing mature adipocytes and skeletal muscle fibers. Therefore, surgery was terminated without further resection. No recurrence occurred during a follow-up of five years after surgery.

CONCLUSION

Recurrent IML in the wrist must be examined to differentiate it from sarcoma. Damage to surrounding tissues should be minimized during excision.

Keywords: Intramuscular; Lipoma; Recurrence; Wrist; Case report

Core Tip: Lipoma is one of the most common benign tumors. Intramuscular lipoma (IML) is a lipoma that has invaded the muscular layer, sometimes with unclear boundaries. It may recur if complete resection is not performed. IMLs that recur with unclear boundaries might need to be differentiated from soft tissue sarcoma. Therefore, imaging tests such as computed tomography or magnetic resonance imaging should be performed before surgery and a thorough preoperative plan should be established to reduce recurrence and preserve hand function.