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Recurrent lipoma: an uncommon presentation in the wrist after incomplete excision
Marc D Mazur1, Tinatin Natroshvili1, Sandra J M Jongen1
1Department of Plastic Surgery, Martini Hospital Groningen.
Patient:
Female, 58-year-old.
Final Diagnosis:
Benign recurrent lipoma following incomplete surgical removal.
Symptoms:
Discomfort, Aesthetic Dissatisfaction.
Clinical Procedure:
Surgical Revision-Excision-Exploration with Lipoma Extraction.
Specialty:
Plastic Surgery (Hand Surgery).
Objective:
Unusual Clinical Presentation and Course.
Background:
Lipoma is a usually painless tumor composed of adipocytes, of fat cells, arising from mesenchymal tissue. It manifests itself in locations in the body where adipocytes are and has circumscribed growth. Its incidence in the hand is relatively low (1%-4.9%). Despite most lipomas being benign and usually asymptomatic, the location of lipoma can lead to nerve compression symptoms. We report a case of an unusual recurrence of lipoma in the wrist after incomplete excision.
Case Report:
A 58-year-old female presented with a large, soft mass located on the volar side of the wrist, which recurred during the first week following the initial excision. While the patient did not exhibit symptoms of nerve compression, she reported experiencing swelling and pain at the surgical site postoperatively. The patient underwent surgical re-excision of the lesion, and the excised tissue was sent for histological examination. The subsequent histological analysis confirmed the diagnosis of a benign lipoma. The patient expressed satisfaction with the surgical revision, postoperative care, and outcomes, reporting high levels of contentment in pain relief, functional improvement, and cosmetic results.
Conclusions:
Lipomas often remain asymptomatic for extended periods, only becoming a source of discomfort or concern once they increase in size or impact one's appearance. Although most lipomas are benign and pose little risk to overall health, certain malignant variants exist. Recurrence of lipoma is uncommon and typically suggests an incomplete initial excision. In anatomically complex regions like the hand or wrist, meticulous planning and preoperative imaging are essential to prevent compression, exclude malignancy, and preserve function.
