Giant lipoma of the hand located between the digital nerves of the thumb: a case report

Giant lipomas (>5 cm) in the hand are rare soft tissue masses. Most reported cases were localized to the palm, with occasional involvement of digital nerves other than the thumb. This report describes a unique case of a giant lipoma radially deviated between the digital nerves of the thumb. A 45-year-old woman presented with a progressively enlarging, soft, non-tender mass in her left hand that had been present for 3 years. The mass extended from the palm to the first web space, causing pain, functional impairment, and cosmetic concerns, prompting surgical removal. Preoperative magnetic resonance imaging revealed a well-encapsulated, lipid-rich tumor (6×4×3 cm) near the median nerve, with the radial digital nerve of the thumb positioned between the tumor and the skin. Marginal excision was performed without nerve injury. Histopathology confirmed a benign lipoma. The patient remained symptom-free postoperatively, with no recurrence at a 1-year follow-up. This case highlights the importance of preoperative imaging to assess anatomical relationships and the necessity of surgical intervention for functional/cosmetic issues related to giant lipomas in the hand.