Lipomas in the hand and wrist

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OF all the benign soft-tissue tumors, lipomas are the most frequently encountered. The presence of a small lipoma on the back or about the hip or shoulder is seldom even mentioned in a routine physical examination unless the patient has some symptoms referable to the tumor. The doughy, cystic feeling of a subcutaneous lipoma is so typical that the examining physician may assure his patient that the tumor is benign and excision is not necessary unless the tumor is causing pain, is increasing in size, or is lying in a region that is subject to constant irritation.

Despite the fact that there is a moderate amount of fat distributed throughout the hand and wrist, lipomas in these sites are not common. Less than 50 lipomas of the hand have been reported in the literature, and the majority of these reports were of a single case.1–4 In a series of 500 benign subcutaneous tumors of the hand seen at our institution during a 10-year period, there were only seven lipomas.5

We have recently reviewed the records of all patients with the diagnosis of lipoma of the upper extremity, seen at the Cleveland Clinic during the period 1948 to 1967.6 There were 247 patients in this series; 112 patients underwent surgical excision of the tumors, and pathologic examination revealed a benign lipoma in each specimen.

In our series of 112 pathologically proved lipomas there were 12 in the hand—one affecting the entire palm, two each in the thenar eminence, four each . . .



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