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case_images: Physical examination of the right hand showing a thenar mass and scar from previous surgical procedure.
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case_images: On examination, there was a mass on the thenar eminence (Fig. 1).
case_images: T1-weigthed axial MRI image showing an occupying-space lesion with hypersignal.
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case_images: Ultrasound (US) and magnetic resonance image (MRI) of the hand revealed an occupying-space lesion of adipose density, capsulated with well-defined contours (Fig. 2, Fig. 3).
case_images: T1-weigthed coronal MRI image showing a capsulated adipose tumour without tendon involvement.
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case_images: MRI showed no signs of local aggressivity and presented a large homogenous tumour measuring approximately 46 x 31 x 17 mm, shaping the flexor tendons and median nerve, but laying independently from them (Fig. 4).
case_images: T1-weigthed sagittal MRI image showing a capsulated adipose tumour shaping the flexor tendons, with signs of invasion.
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case_images: The median nerve presented no focal lesions, but it was distally molded and rectified by the presence of the tumour (Fig. 5).
case_images: Intraoperative picture. Surgical standard palmar approach, with an intracanal lipoma.
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case_images: Through a standard palmar approach and anterior annular carpal ligament release, an intracanal giant lipoma was found (Fig. 6).
case_images: Intraoperative picture. Dissection of intracanal lipoma, laying above the median nerve.
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case_images: Tumour dissection was complete and an en bloc marginal resection carried out (Fig. 7, Fig. 8).
case_images: Excised lipoma before fixation.
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case_images: The histopathological analysis documented a nodular, elastic fragment of soft tissue, loculated and yellow in colour, weighting 13 g and measuring 51 x 35 x 25 mm (Fig. 9).
case_images: Histopathological analysis showing mature adipose tissue.
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case_images: The lesion was constituted by mature adipose tissue (Fig. 10) and the definitive diagnosis was a benign giant lipoma.