Recurrent intramuscular lipoma at extensor pollicis brevis: A case report

Area of Science:

• Orthopedic Surgery
• Surgical Oncology
• Diagnostic Imaging

Background:

• Intramuscular lipomas (IMLs) are benign fatty tumors typically found in large muscles.
• Recurrence of IMLs is uncommon, and complete excision is often necessary, especially for those with indistinct margins.
• IMLs in the hand are infrequently reported, with no prior cases documented along the extensor pollicis brevis (EPB) muscle and tendon.

Observation:

• A 42-year-old woman presented with a recurrent forearm and wrist mass, previously treated for lipoma.
• Magnetic resonance imaging revealed a lipomatous mass invading the EPB muscle layer.
• Histopathological examination confirmed the diagnosis of intramuscular lipoma.

Findings:

• The recurrent intramuscular lipoma of the extensor pollicis brevis was successfully excised.
• The patient experienced no recurrence during a five-year follow-up period.
• Surgical intervention focused on minimizing damage to surrounding tissues.

Implications:

• Accurate differentiation of recurrent IML from soft tissue sarcoma is crucial in wrist and forearm masses.
• Careful surgical technique is essential to prevent damage to adjacent structures during IML excision.
• This case expands the understanding of IML presentation and management in the EPB.