Recurrent lipoma: an uncommon presentation in the wrist after incomplete excision

Abstract

Patient

Female, 58-year-old

Final Diagnosis

Benign recurrent lipoma following incomplete surgical removal.

Symptoms

Discomfort, Aesthetic Dissatisfaction

Clinical Procedure

Surgical Revision-Excision—Exploration with Lipoma Extraction

Specialty

Plastic Surgery (Hand Surgery)

Objective

Unusual Clinical Presentation and Course

Background

Lipoma is a usually painless tumor composed of adipocytes, of fat cells, arising from mesenchymal tissue. It manifests itself in locations in the body where adipocytes are and has circumscribed growth. Its incidence in the hand is relatively low (1%−4.9%). Despite most lipomas being benign and usually asymptomatic, the location of lipoma can lead to nerve compression symptoms. We report a case of an unusual recurrence of lipoma in the wrist after incomplete excision.

Case report

A 58-year-old female presented with a large, soft mass located on the volar side of the wrist, which recurred during the first week following the initial excision. While the patient did not exhibit symptoms of nerve compression, she reported experiencing swelling and pain at the surgical site postoperatively. The patient underwent surgical re-excision of the lesion, and the excised tissue was sent for histological examination. The subsequent histological analysis confirmed the diagnosis of a benign lipoma. The patient expressed satisfaction with the surgical revision, postoperative care, and outcomes, reporting high levels of contentment in pain relief, functional improvement, and cosmetic results.

Conclusions

Lipomas often remain asymptomatic for extended periods, only becoming a source of discomfort or concern once they increase in size or impact one’s appearance. Although most lipomas are benign and pose little risk to overall health, certain malignant variants exist. Recurrence of lipoma is uncommon and typically suggests an incomplete initial excision. In anatomically complex regions like the hand or wrist, meticulous planning and preoperative imaging are essential to prevent compression, exclude malignancy, and preserve function.

Keywords:

• Lipoma
• reoperation
• guyon canal
• carpal tunnel
• recurrence
• hand
• surgery
• hand

Author contributions

MM wrote the manuscript. MK and SJ performed the surgical procedures. All authors have read and approved the final manuscript.

Consent for publication

Written informed consent was obtained from the patient for publication of this case report and any accompanying images.