Lipoma causing triggering finger at the wrist and median nerve compression treated with endoscopic carpal tunnel release surgery: A case report

Trigger finger at the wrist, caused by palmar lipoma combined with carpal tunnel syndrome, is a rare condition that is typically managed through surgical intervention using palmar-to-forearm incision surgery. To minimize surgical intervention, we utilized endoscopically-assisted observation and resection of the tumor. A 56-year-old patient presented with complaints of left middle finger triggering, palmar tingling, and upper-extremity fatigue. Provocation tests and nerve conduction studies revealed the presence of carpal tunnel syndrome. Magnetic resonance imaging (MRI) demonstrated a tumor located distal to the carpal canal with high T1/T2 weighted intensity and positive fat suppression. After endoscopic carpal tunnel release, the tumor was observed from the endoscopic portal with full finger flexion and then the tumor was excised. The pathological diagnosis confirmed a benign lipoma. Clinical symptoms disappeared immediately following the procedure. We report a rare case of lipoma originating from the flexor digitorum superficialis locking in the carpal tunnel, and provide an endoscopic treatment option for this pathological condition.