Faculty Collaboration Database

Lipomas of the Brachial Plexus: A Case Series and Review of the Literature. Hand (N Y) 2019 May;14(3):333-338

Date

10/24/2017

Pubmed ID

29058949

Pubmed Central ID

PMC6535949

DOI

10.1177/1558944717735946

Scopus ID

2-s2.0-85041635235 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

BACKGROUND: Lipomas are common benign tumors. When they develop in proximity to peripheral nerves, they can cause neurologic symptoms secondary to mass effect. Previous reports have shown symptom resolution after removal of lipomas compressing various upper extremity peripheral nerves. However, brachial plexus lipomas are relatively rare. Our multidisciplinary experience with brachial plexus lipoma resection is reviewed in the largest case series to date.

METHODS: A retrospective chart review of all patients undergoing resection of brachial plexus lipomatous tumors between 2006 and 2016 was performed. Patient demographic data, diagnostic imaging, clinical presentation, operative details, surgical pathology, and clinical outcomes were reviewed.

RESULTS: Twelve brachial plexus lipomatous tumors were resected in 11 patients: 10 lipomas, 1 hibernoma, and 1 atypical lipomatous tumor. The most common tumor location was supraclavicular (50%), followed by axillary (42%), and proximal medial arm (8%). The most common brachial plexus segment involved was the upper trunk (50%), followed by posterior cord (25%), lateral pectoral nerve (8%), lower trunk (8%), and proximal median nerve (8%). Most patients presented with an enlarging painless mass (58%). Of the patients who presented with neurologic symptoms, symptoms resolved in the majority (80%).

CONCLUSIONS: Brachial plexus lipomas are rare causes of compression neuropathy in the upper extremity. Careful resection and knowledge of brachial plexus anatomy, which may be distorted by the tumor, are critical to achieving a successful surgical outcome with predictable symptom resolution. Finally, surveillance magnetic resonance imaging may be warranted for atypical lesions.

Author List

Graf A, Yang K, King D, Dzwierzynski W, Sanger J, Hettinger P

Authors

William W. Dzwierzynski MD Professor in the Plastic Surgery department at Medical College of Wisconsin
Alexander Reed Graf MD Assistant Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
David M. King MD Chair, Professor in the Orthopaedic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Arthrogryposis
Brachial Plexus
Female
Hereditary Sensory and Motor Neuropathy
Humans
Lipoma
Magnetic Resonance Imaging
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Upper Extremity