Distribution of intramuscular giant lipomas in the functional compartments of the forearm: a report of 12 cases

Endoscopic En-Bloc Resection of Intra-Muscular Lipoma of the Flexor Digitorum Profundus: A Uniportal Technique

Deep-seated lipomas can be intramuscular, intermuscular, and rarely, parosteal lipomas. Intramuscular lipoma can be divided into infiltrative, well-circumscribed, and mixed types. Marginal excision is the treatment of choice for well-circumscribed intramuscular lipoma, and histopathology eliminates diagnosis of well-differentiated liposarcoma. The purpose of this technical note is to describe the details of endoscopic en-bloc resection of intramuscular lipoma of the flexor digitorum profundus. This minimally invasive approach allows en-bloc resection of the lipoma for histopathological study, with minimal risk to the surrounding neurovascular structures.

Upper extremity mass with lipomatous axillary involvement and multiple level encasement of the brachial plexus

A 40-year-old female presented for surgical consultation of an upper extremity soft tissue mass. Initial ultrasound report recorded a 5.5 cm mass, consistent with a subcutaneous lipoma. Intra-operative visualization revealed an intramuscular lipoma emerging from brachialis muscle. Post-excision MRI was ordered for continued axillary fullness which revealed lipomatous extension into axilla and posterior arm with multiple level encasement of the brachial plexus. Lipomas with brachial plexus involvement are rare and can present with a range of symptoms and distortion of local anatomy. Surgical debulking is challenging requiring microsurgical expertise for adequate removal and to minimize long-term neurological deficits.