Pedunculated lipofibroma (Hoffmann-Zurhelle) on the palm.

A 47-year-old woman presented with a 1-year history of a nodule on her right palm. She stated that the lesion had originally appeared without any trigger one year previously and that it had gradually increased in size. Physical examination revealed a pedunculated, solitary, asymptomatic nodule, 30 × 30 mm (Fig. 1). The prominent stalk was 8 mm long. The nodule was smooth, skin-coloured and soft. Histopathological examination revealed a slightly acanthotic epidermis with flattened rete ridges. Both the papillary and reticular dermis were thin and contained scattered lobules of fat cells entrapped between bundles of dermal collagen fibres. Great irregularity in the dermal-subcutaneous interface was observed as a result of the marked increase in adipose tissue. In the dermis, moderately dense perivascular lymphocytic infiltrates were observed, and adnexal structures were absent (Fig. 2 a, b). Based on these findings, the diagnosis of pedunculated lipofibroma was established. The nodule was completely excised and there has been no recurrence for 2 years.