PMC7289738_01
Lump on the volar side of right forearm.
gr1.jpg
PMC7289738_01_gr1.jpg
fig0005
The right forearm circumference was 20 cm compared to 7 cm on the contralateral (Fig. 1).
A more radiolucent soft tissue mass compared to surroundings on the volar part of right forearm on the level of proximal shaft radius-ulna to metaphyseal region of distal radius-ulna. Cortical thickening was noted on mid-shaft radius. No bony destruction or lesions were observed.
gr2.jpg
PMC7289738_01_gr2.jpg
fig0010
Patient underwent radiograph assessment with plain x ray which suggest lipomatous mass (Fig. 2) and Magnetic Resonance Imaging (MRI) which concluded a prominent lipomatous mass on intermuscular region with possible benign lesion or low-grade malignancy (Fig. 3).
Yellowish lipomatous mass with pseudo-capsule. (a) The mass was subcutaneously located on the wrist region with proximity to the median n. (arrow) and (b) became intermuscular as it extended deep into the more proximal location on the forearm and occupied the space between FCR and FDC muscle. (c) The tumor was detached from FPL (arrow) as its deepest adjacent structure. (d) Final clinical picture after tumor removal.
gr4.jpg
PMC7289738_01_gr4.jpg
fig0020
The mass was found to compress the surroundings; however, it was relatively easy to remove due to the pseudo-capsule and the intermuscular location (Fig. 4).
Lobulated, well circumscribed, well-vascularized and rubbery yellowish mass with a firmer area on its superior pole. There were no fat necrosis or hemorrhage. (a) before divided, (b) inner side, and (c) outer side.
gr5.jpg
PMC7289738_01_gr5.jpg
fig0025
The mass consistency was generally rubbery with a firmer consistency at the superior pole. (Fig. 5).
Histopathological picture in HE staining with various magnification. There was adipose cell proliferation with varying size and scattered atypical cells, of which, some has nucleoli. (a) 40x, (b) 100x, and (c) 400x magnification.
gr6.jpg
PMC7289738_01_gr6.jpg
fig0030
Clinical appearance at one year follow up.
gr7.jpg
PMC7289738_01_gr7.jpg
fig0035
At one-year follow-up the scar healed nicely without recurrence of the mass (Fig. 7).