Yonsei Med J.  2005 Feb;46(1):169-172. 10.3349/ymj.2005.46.1.169.

Symmetric Lipofibromatous Hamartoma Affecting Digital Nerves

• Jung SN
• Yim Y
• Kwon H

• KMID: 2158130
• DOI: http://doi.org/10.3349/ymj.2005.46.1.169

Abstract

Lipofibromatous hamartoma of the nerve is a benign tumor, which affects the major nerves and their branches in the human body. It is often found in the median nerve of the hand and is commonly associated with macrodactyly, but it is rarely found in the digital nerves at the peripheral level. This tumor is often found in young adults and may go through a self- limiting course. However, operation is indicated when the tumor size is large or when the associated nerve compressive symptoms are present. We have experienced a rare case of lipofibromatous hamartoma that symmetrically involved the volar digital nerves of both index fingers on the ulnar side. With the aid of a microscope, we dissected and removed the tumor as much as possible without sacrificing the nerve. No sensory change occurred in both fingers and no sign of recurrence was observed upon follow-up.

Keyword

Lipofibromatous hamartoma; digital nerve; symmetry

MeSH Terms

Adipose Tissue/pathology
Adult
Female
Fingers/*innervation/pathology
Hamartoma/complications/*pathology
Humans
Nerve Compression Syndromes/etiology/*pathology

Figure

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  Fig. 1 Tumors that were symmetrically growing in the index fingers of both hands.

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  Fig. 2 Specimen that has much fatty content in the digital nerves in the ulnar side.

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  Fig. 3 Histologic finding shows a marked fatty infiltration between the fasciculi, with fibrotic thickening of the endoneurium and perineurium (H&E, × 100).

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  Fig. 4 CD34 immunohistochemical stain shows a positive reaction (× 100).

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  Fig. 5 Postoperative view, 15 months after surgery.

Reference

1. Steentoft J, Sollerman C. Lipofibromatous hamartoma of a digital nerve; a case report. Acta Orthop Scand. 1990. 61:181–182.

2. Johnson RJ, Bonfiglio M. Lipofibromatous hamartoma of the median nerve. J Bone Joint Surg (Am). 1969. 51:984–990.

3. Amadio PC, Reiman HM, Dobyns JH. Lipofibromatous hamartoma of nerve. J Hand Surg Am. 1988. 13:67–75.

4. Akisue T, Matsumoto K, Yamamoto T, Kizaki T, Fujita I, Yoshiya S, et al. Neural fibrolipoma of the superficial peroneal nerve in the ankle: a case report with immunohistochemical analysis. Pathol Int. 2002. 52:730–733.

5. Dell PC. Macrodactyly. Hand Clin. 1985. 1:511–524.

6. Enzinger FM, Weiss SW. Soft tissue tumors. 1983. St. Louis: Mosby.

7. Gouldesbrough DR, Kinny SJ. Lipofibromatous hamartoma of the ulnar nerve at the elbow: brief report. J Bone Joint Surg (Am). 1969. 51:984–990.

8. Kransdorf MJ, Moser RP Jr, Meis JM, Meyer CA. Fat-containing soft-tissue masses of the extremities. Radiographics. 1991. 11:81–106.

9. Callison JR, Thoms OJ, White WL. Fibro-fatty proliferation, of the median nerve. Plast Reconsr Surg. 1968. 42:403–413.

10. Paletta FX, Rybka FJ. Treatment of hamartomas of the median nerve. Ann Surg. 1972. 176:217–222.

11. Patel ME, Silver JW, Lipton DE, pearlman HS. Lipofibroma of the median nerve in the palm and digits of the hand. J Bone Joint Surg (Am). 1979. 61:393–397.