神経内脂肪腫を伴う手根管症候群の1例

Carpal Tunnel Syndrome with Intraneural Lipoma. Case Report

　症例は60歳の女性．特発性手根管症候群と診断し，直視下手根管開放術を施行した．術中，神経外膜下に脂肪腫様腫瘤を認めたため，部分摘出を追加施行した．術後の経過は良好で，病理診断は脂肪腫であった．術前，特発性手根管症候群と診断し，腫瘍の存在を全く予測できなかった．また，特発性なのか腫瘍による手根管症候群なのかを断定することは困難であった．特発性手根管症候群と思われるものにも，自験例のように神経内脂肪腫を伴うものもあり，注意が必要と考えられた．

　The patient was a 60-year-old woman in whom a lipoma-like mass was observed in the subepineurium during an open release operation for idiopathic carpal tunnel syndrome, and partial excision of the mass was performed during the same procedure. The histological diagnosis of the mass was lipoma, and the postoperative course was excellent. We did not consider the possibility of a tumor before the operation, and whether the carpal tunnel syndrome was tumor-induced or idiopathic remains unresolved. It appears that in rare cases carpal tunnel syndrome that is thought to be idiopathic is later discovered to involve an intraneural lipoma, as in our case. Care is needed to diagnose and treat such cases.