Pseudo Carpal Tunnel Syndrome with a Specific Cause: A Report of 2 Cases

Case Report

Austin J Orthopade & Rheumatol. 2024; 11(1): 1126.

Pseudo Carpal Tunnel Syndrome with a Specific Cause: A Report of 2 Cases

Abdelhay Rabah*; Oussama Achahbar; Sbihi Mohammed; M Bousaidane; Y Benyas; J Boukhris; D Bencheba; B Chafry

Department of Orthopedic A Traumatological Surgery, Mohamed V Military Hospital, Rabat-Morocco

*Corresponding author: Abdelhay Raba Department of Orthopedic A Traumatological Surgery, Mohamed V Military Hospital, Rabat-Morocco Email: rabahabdelhay7@gmail.com

Received: November 28, 2023 Accepted: January 01, 2024 Published: January 08, 2024

Introduction

Lipomas, common benign tumors of soft tissues, are particularly rare in the hand, accounting for only 5% of upper limb locations [1]. The manifestation of a giant palmar lipoma, compressing the median nerve, is an exceptional occurrence. This rarity emphasizes the importance of Magnetic Resonance Imaging (MRI) to characterize the lipomatous nature of the lesion and clarify its relationship with palmar vasculonervous structures. Simultaneously, histology plays a crucial role in ruling out differential diagnoses, especially the most dreaded liposarcoma.

The duality between the rarity of the location in the hand and the potential for nerve complications makes palmar lipoma a unique and complex study subject. In this regard, we report two cases of lipomas with a specific digito-palmar location, presenting with dysesthesias and elective motor disturbances in the territory of the median nerve.

Clinical Observations

Case 1

A 60-year-old woman with a history of type 2 diabetes presents with a subcutaneous mass in the right palmar compartment that has been evolving and progressively increasing in size over the past 3 months (Figure 1). The patient maintains a general state of health. Associated with acroparesthesias in the first three fingers, the physical examination reveals a firm and painless mass in the thenar eminence, with a positive Tinel test.