Intraneural lipoma of the median nerve

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INTRANEURAL lipoma of the median nerve occurs rarely and, when the nature of the lesion is not recognized, presents a problem of treatment. The intraneural lipoma is benign, affects an entire section of the nerve, and has a characteristic gross appearance. When this benign condition is recognized the appropriate treatment can be instituted. The description of intraneural lipoma or a discussion of the treatment is not included in most published series of nerve tumors, as there have been only 18 reported cases.1–10 Our report is of two cases of intraneural lipoma, each with a characteristic gross appearance, and a discussion of the mode of treatment.

Report of cases

Case 1. A 22-year-old Caucasian man was examined because for six months he had been having numbness of the right hand. Seven months before examination, he noticed a mass in his right palm. The mass enlarged, and decreased sensation in the thumb, index, and middle fingers ensued five months before examination. He also noted that whenever pressure was placed on the palm, there was a burning, tingling sensation in the thumb, and in the index and the ring fingers. He had no history of other disease processes or masses elsewhere in the body.

Results of the general physical examination and laboratory tests were normal. The patient had full range of motion of the wrist and fingers. There was slight atrophy of the thenar eminence, and a palpable, firm, indurated, cystic mass, 2 cm in diameter, was present over the palm and . . .



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