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      Lipomas y compresión nerviosa

      Cirugía Plástica Ibero-Latinoamericana
      Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE)
      Lipoma, Nerve compression syndrome, Lipomas, Síndromes de compresión nerviosa

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          Abstract

          Los lipomas son los tumores de tejidos blandos más frecuentes del organismo, pudiéndose presentar en cualquier localización. Habitualmente son asintomáticos, pero en ocasiones pueden producir clínica de compresión nerviosa. El objetivo de nuestro trabajo es revisar nuestra experiencia en el tratamiento de lipomas que producen compresión nerviosa. Ante la presencia de clínica de compresión nerviosa junto con tumoración de crecimiento lento debemos sospechar el diagnóstico de lipoma. Es muy importante la planificación quirúrgica adecuada, ayudada por las pruebas de imagen tipo Resonancia Nuclear Magnética (RNM), puesto que las estructuras nerviosas pueden estar incluidas en el lipoma.

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          Most cited references23

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          Peripheral nerve compression secondary to adjacent lipomas.

          Nonneural sheath origin tumors include some rare benign and malignant lesions, and the compression of peripheral nerves by benign fatty tumors is infrequently reported in the medical literature. This study aims to review the authors' experience in treating patients with peripheral nerve compressions secondary to adjacent lipomas. This study is a retrospective analysis of data about the patients who presented peripheral nerve compressive symptoms secondary to lipomas in the upper and lower limbs, treated during the period of 1999 to 2006. Included in the cases were those wherein the tumor was in contact with the nerve and the symptoms matched a respective nerve sensitive and/or motor innervation pattern. The upper extremity was the site of 5 (62.5%) of 8 lipomas, followed by the lower limb (2 lesions, 25%), and 1 tumor involved the brachial plexus (12.5%). In 5 cases, the clinical picture was similar to some entrapment neuropathy. Ultrasound imaging was useful to define the mass as a nonneural sheath origin tumor; MRI allowed a better analysis of the relationship of the tumor with other vascular, bony, or ligamentous structures. The lesions were ressected in all the patients, and there was good outcome in 7 cases (87.5%). Otherwise, we could identify signs of external compression on the direct inspection of the involved nerves in only 2 cases. The surgical treatment offers good outcomes in pain relief and neurological recovery, but one should not expect a real compression effect of the lipoma on the nerve during surgery.
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            Posterior interosseous nerve palsy due to parosteal lipoma.

            Lipomas are extremely common benign soft tissue tumours that are usually subcutaneous and asymptomatic. Occasionally, lipomas can occur in deeper soft tissue planes and when adjacent to the neck of the radius they can cause compression of the posterior interosseous nerve. Five such cases are described. An anterior approach to excision of the lipoma is recommended.
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              Classification of benign fatty tumours of the upper limb.

              In this paper, the authors offer a classification of benign fatty tumours of the upper limb. There are three histologically distinct types of fat cells: immature fat cells which give rise to lipoblastomas, mature brown fat cells which give rise to hibernomas and mature white fat cells which give rise to lipomas. Lipomas are the most common and they are sub-classified according to the anatomic site of fat cells into dermal, subcutaneous and sub-fascial lipomas; or tumours directly related to muscle, bone, synovium or nerve. Finally, the authors review 67 patients with benign fatty tumours of the upper limb and provide clinical examples of these tumours including their characteristic histological and radiological features.
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                Author and article information

                Journal
                S0376-78922010000100008
                10.4321/s0376-78922010000100008
                http://creativecommons.org/licenses/by/4.0/

                Surgery
                Lipoma,Nerve compression syndrome,Lipomas,Síndromes de compresión nerviosa
                Surgery
                Lipoma, Nerve compression syndrome, Lipomas, Síndromes de compresión nerviosa

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