gms | German Medical Science

Objectives/Interrogation: Lipoma is the most common soft tissue tumor occurring anywhere in the body, and is generally regarded harmless. Most of them arise superficially, and deep lipomas are far rare. Lipoma seldom affects peripheral nerve function, but deep lipoma arising in the elbow may cause disturbances due to its proximity to radial nerve. We have experienced four cases of lipoma around the elbow, and here we reported the results with thorough literature review.

Methods: All four patients were middle-aged females, and their age ranged from 57 to 68 years. All tumors located at radial side of the elbow, and were deep-seated. One patient did not complain any symptom other than soft tissue mass. In the remaining three patients, one complained of inability to extend her left ring and little fingers, and the other two noticed pain or numbness. All tumors were pathologically confirmed as benign lipoma after surgical resection.

Postoperative follow-up period ranged from one to 12 months.

Results and Conclusions: The patient with posterior interosseous nerve palsy, complete recovery was obtained 6 months after surgery. In three patients with or without symptoms, superficial branch of radial nerve run over the tumor, attaching the capsule, and posterior interosseous nerve was involved by the tumor in one of them. Meticulous dissection was undertaken during surgery.

During resection of lipoma in the upper extremity, peripheral nerves sometimes exist besides the tumor. White & Hanna reported a series of lipomata arising in the upper extremity, half of which were called as "troublesome lipoma", presenting with nerve palsy, pain or discomfort. Typical troublesome lipoma is the case arising around the radial neck with posterior interosseous nerve palsy, approximately 30 cases of which have been reported. It is important to carefully evaluate patients with lipoma in the elbow region, and atraumatic dissection is required to avoid postoperative nerve complication.