Lipomatous Mass Effect on the Brachial Plexus: A Case Report.
Adrian O Campos1, Daniel Blatt1, Rehan Zahid1
1Plastic and Reconstructive Surgery, University of Iowa Hospitals and Clinics, Iowa City, USA.
Cureus
|May 7, 2025
Summary
A large axillary lipoma caused peripheral nerve compression, mimicking carpal tunnel syndrome and cubital tunnel syndrome. Surgical removal of the lipoma and brachial plexus decompression resolved symptoms, highlighting the need to consider brachial plexus pathology in nerve entrapment cases.
Area of Science:
- Neurology
- Orthopedic Surgery
- Surgical Pathology
Background:
- Peripheral nerve compression, including carpal tunnel syndrome (CTS), is common.
- Less common nerve entrapment syndromes require recognition of underlying causes, such as brachial plexus issues.
Observation:
- A 57-year-old male presented with median and ulnar nerve compression symptoms due to an enlarging axillary mass.
- Symptoms included numbness, tingling, and weakness in the left hand, exacerbated by certain movements.
- A history of an untreated axillary lipoma was noted, with examination revealing a large, adherent mass.
Findings:
- Electromyography suggested ulnar and median nerve compression, with possible brachial plexopathy.
- MRI confirmed the lipoma compressing the brachial plexus and axillary vasculature.
- Surgical intervention involved lipoma excision, brachial plexus neurolysis, and cubital tunnel release.
Implications:
- This case highlights the importance of considering brachial plexus pathology in patients with peripheral nerve compression symptoms.
- Prompt diagnosis and surgical management of extrinsic nerve compression can lead to complete symptom resolution.
- Accurate evaluation of axillary masses is crucial for identifying potential neurological complications.
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