A large Guyon’s canal lipoma without neuropathy in a child
- 35 Downloads
- 1 Citations
Abstract
Lipomas originating from Guyon’s canal are uncommon tumors. There are rare reports of adult cases, often with nerve compression findings. However, so far, no report had described this tumor in the pediatric age group. This article presents an 8-year-old boy who presented with a 3-year history of slowly growing hypothenar mass. Exploration yielded a large lipoma (35×55×44 mm) originating from the proximal Guyon’s canal, which resides within the hypothenar musculature. The lesion was excised totally, and histological evaluation confirmed the diagnosis. The follow-up period was uneventful, and complete cure was attained. To the best of our knowledge, this is the first report of a lipoma deriving from the Guyon’s canal in a child. Despite its huge mass, no signs of nerve compression were detected. This inconsistency between children and adult patients may be due to anatomical and physiological differences of the Guyon’s canal and attending nerves and muscles. In children, the structures forming the canal may be more expandable to let such a bulk grow without neuropathy.
Keywords
Guyon’s canal Lipoma Children Ulnar nerve compressionLipome du canal de Guyon
Résumé
Les lipomes du canal de Guyon sont des tumeurs rares. La littérature retrouve des cas de lipomes du canal de Guyon chez l’adulte souvent associés à une compression nerveuse. A notre connaissance il n’y a pas eu encore de description d’une telle lésion chez l’enfant. Cet article présente un garçon de 8 ans, qui présente une masse hypothénar évoluant depuis 3 ans. L’intervention permit de retrouver un volumineux lipome (35×55×44 mm) de la partie proximale du canal de Guyon à côté du muscle. La lésion fut excisée en totalité et confirmée à l’examen histologique. L’évolution post-opératoire fut sans particularité. A notre connaissance c’est le premier article présentant un lipome du canal de Guyon chez l’enfant. Malgré son volume, aucun signe de compression neurologique n’a été retrouvé. La différence avec les cas de l’adulte peut être due à des différences anatomiques et physiologiques du canal de Guyon et liée aux nerfs et aux muscles. Chez l’enfant, les structures formant le canal doivent être plus souples permettant à une tuméfaction de grossir sans lésions nerveuse.
Mots clés
Canal de Guyon Lipome Enfants Compression du nerf cubital UlnaireReferences
- 1.Babins DM, Lubahn JD (1994) Palmar lipomas associated with compression of the median nerve. J Bone Joint Surg Am 76:1360–1362PubMedGoogle Scholar
- 2.Bui-Mansfield LT, Williamson M, Wheeler DT, et al. (2002) Guyon’s canal lipoma causing ulnar neuropathy. AJR Am J Roentgenol 178:1458PubMedGoogle Scholar
- 3.Dell PC (1979) Compression of the ulnar nerve at the wrist secondary to a rheumatoid synovial cyst: case report and review of the literature. J Hand Surg Am 4:468–473PubMedGoogle Scholar
- 4.Galeano M, Colonna M, Risitano G (2001) Ulnar tunnel syndrome secondary to lipoma of the hypothenar region. Ann Plast Surg 46:83–84CrossRefPubMedGoogle Scholar
- 5.Gross MS, Gelberman RH (1985) The anatomy of the distal ulnar tunnel. Clin Orthop 196:238–247PubMedGoogle Scholar
- 6.Gruber P, Towfigh H (2002) Lipoma as a rare cause of nerve compression syndrome in the hand and forearm. Handchir Mikrochir Plast Chir 34:17–21CrossRefPubMedGoogle Scholar
- 7.Kothari MJ (1999) Ulnar neuropathy at the wrist. Neurol Clin 17:463–476PubMedGoogle Scholar
- 8.Nakamichi K, Tachibana S, Kitajima I (2000) Ultrasonography in the diagnosis of ulnar tunnel syndrome caused by an occult ganglion. J Hand Surg Br 25:503–504CrossRefPubMedGoogle Scholar
- 9.Rengachary SS, Arjunan K (1981) Compression of the ulnar nerve in Guyon’s canal by a soft tissue giant cell tumor. Neurosurgery 8:400–405PubMedGoogle Scholar
- 10.Shea JD, McClain EJ ( 1969) Ulnar nerve compression syndromes at and below the wrist. J Bone Joint Surg Am 51:1095–1103PubMedGoogle Scholar
- 11.Wong CH, Chow L, Yen CH, et al (2001) Uncommon hand tumors. Hand Surg 6:67–80CrossRefPubMedGoogle Scholar
- 12.Zahrawi F (1984) Acute compression ulnar neuropathy at Guyon’s canal resulting from lipoma. Hand Surg Am 9:238–239Google Scholar