a Ceballos Æ Paul Wylock
Hand palm and ﬁnger lipomas: four case reports and
review of the literature
Received: 16 September 2004 / Accepted: 3 January 2005 / Published online: 11 May 2005
Ó Springer-Verlag 2005
Abstract Lipomas occur anywhere in the body, but are
rarely found in the ﬁngers (Kalisman and Beck ).
Lipomas in the deep palmar spaces of the hand are also
unusual tumors (Oster ). Two hand lipomas—one in
the deep palmar space and one in the thenar emi-
nence—and two ﬁnger lipomas were found in our
practice between January 2002 and 2004 are reported.
Keywords Hand palm lipoma Æ Finger lipoma
Lipomas are common tumors that arise from mesen-
chymal primordial fatty-tissue cells. Their localisation is
infrequent in the deep palmar space and ﬁnger as ob-
served by Posch . They represent 1–3.8% of the be-
nign tumors of the hand [2, 3]
We present four cases: two hand and two ﬁnger
lipomas collected in our practice over a period of
Case report 1
A 72-year-old healthy retired male oﬃce worker pre-
sented complaining of a large mass on the palm of his
left hand. This mass had been a small lump for a period
of 10 years and had signiﬁcantly increased in size over
the past year. It was not painful and there were no
associated paraesthesias. The patient had no functional
deﬁcit. It did not interfere with his grasping ability.
On examination there was a 4·4 mass on the palm of
the left hand; it was soft and non-tender on palpation.
No change in the skin colour was noticed. Sensation and
function tests were normal.
An ultrasound examination showed a large hypore-
ﬂective mass compatible with an intramuscular lipoma.
Surgical excision was advised. This was performed
under general anaesthesia with a tourniquet in place.
This allowed a careful dissection to be undertaken.
A lobulated yellow mass was exposed. It was situated
posterior to the palmaris fascia. The tumor was easily
removed (Fig. 1). A Penrose drain was left in for some
The postoperative period was uneventful. The his-
tology was that of a lipoma.
Case report 2
A 55-year-old woman presented complaining of a large
mass on her right thenar eminence and two other bulging
areas, one immediately anterior to the extensor pollicis
brevis tendon and the other on the dorsum of the wrist.
The thenar mass had been present for a period of 2 years
and was slowly increasing in size. She had no pain and no
paraesthesias. From the functional viewpoint, she expe-
rienced certain diﬃculty when grasping objects.
On examination she had a 4·4 mass in the left palm.
There were also two small masses: one located anterior
to the ﬁrst extensor compartment and the other on the
dorsal aspect of the wrist. All masses were soft and non-
tender on palpation. No change on the skin colour was
noticed. Sensation was normal. Extension, abduction,
adduction and ﬂexion of the thumb were normal,
opposition was diﬃcult.
An ultrasound showed a hyporeﬂective large mass
compatible with an intramuscular lipoma.
Surgical excision was advised. The surgery was per-
formed under general anaesthesia with a tourniquet in
J. I. Garcı
a Ceballos (&) Æ P. Wylock
Department of Plastic, Reconstructive and Aesthetic Surgery,
Academisch Ziekenhuis, Vrije Universiteit Brussel,
Laarbeeklaan 101, 1090 Brussels, Belgium
Eur J Plast Surg (2005) 28: 243–246