Compressive Neuropathy of the Ulnar Nerve in the Hypothenar Region by Lipoma: Case Report

  • de Magalhães M
  • Oliva H
  • Nunes B
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Abstract

Lipomas are well-defined tumors of the adipose tissue that often occur in the torso or the extremities of adult patients. These tumors usually develop painlessly and insidiously, but they may compress adjacent structures. The objective of the present study is to describe the case of a 68-year-old female patient with a giant lipoma located at the hypothenar region, with manifestation of compression of the common palmar digital nerves, the ulnar nerve, and the abductor muscle of the V finger. Regarding the symptoms, the patient felt moderate pain in the hypothenar region, with no Tinel sign, and no changes in the motor function or sensibility of the digits innervated by the ulnar nerve. Lipomas may present a varied range of histological characteristics, and malignant tumors may be a differential diagnosis. An imaging exam may aid in the diagnosis, which is confirmed by a histopathological study. For the present case, as recommended in the literature, a surgical procedure was performed for the resection of the tumor, which resulted in the control of the symptoms.Lipomas são tumores bem definidos, de tecido adiposo, presentes no tronco ou nas extremidades, e que ocorrem em pacientes adultos. Esses tumores geralmente se desenvolvem sem dor e de forma insidiosa, podendo, no entanto, comprimir estruturas adjacentes. Este trabalho objetiva descrever o caso de uma paciente do sexo feminino, de 68 anos, com lipoma gigante localizado na face hipotenar, com manifestação de compressão dos nervos digitais palmares comuns, do nervo ulnar, e do músculo abdutor do V dedo. Como sintoma, ela apresentava quadro de dor moderada na face hipotenar, sem sinal de Tinel, e sem alterações da motricidade ou sensibilidade dos dígitos inervados pelo nervo ulnar. Os lipomas podem apresentar variada gama de características histológicas, e o diagnóstico diferencial pode incluir tumores malignos. O exame de imagem pode auxiliar no diagnóstico, o qual é confirmado por meio de estudo histopatológico. Para o presente caso, conforme preconizado na literatura, foi realizado um procedimento cirúrgico para a ressecção do tumor, que resultou no controle dos sintomas.

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APA

de Magalhães, M. J. S., Oliva, H. N. P., & Nunes, B. L. (2020). Compressive Neuropathy of the Ulnar Nerve in the Hypothenar Region by Lipoma: Case Report. Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery, 39(01), 049–053. https://doi.org/10.1055/s-0038-1623517

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