Conventional and Cellular Atypical Lipomas of the Hand and Forearm: A Report of 9 Cases

PurposeTo report a case series of atypical lipomas of the hand and forearm and review the literature to define the clinical presentation, surgical approach, and postoperative complications including recurrence.MethodsAll cases of atypical lipomas of the hand and forearm treated by the author between 1994 and 2010 were retrospectively reviewed. The charts were reviewed for age, gender, tumor site, symptoms, preoperative studies, tumor size, type of surgical excision, and postoperative complications including recurrence.ResultsNine cases were identified. All patients were middle-aged adults with a mean age of 55 years (range, 40–65 years). There were 5 women and 4 men. All patients presented with a single, painless, enlarging mass in either the palm or the volar forearm. Magnetic resonance imaging showed the tumors to be hyperintense on T1- and hypointense on T2-weighted images. All patients had marginal excision of the tumor. Histologically, 5 tumors were conventional, and 4 tumors were cellular atypical lipomas. The mean follow-up was 10 years (range, 6–16 years). There was no evidence of recurrence by clinical examination at final follow-up.ConclusionsThe results of the current series and a review of the literature suggest that atypical lipomas of the hand and forearm may have a more benign behavior than atypical lipomas of other anatomical sites.Type of study/level of evidenceTherapeutic IV.