J Korean Orthop Assoc.  2012 Aug;47(4):316-320. 10.4055/jkoa.2012.47.4.316.

Recurrent Lipofibromatous Hamartoma of the Median Nerve

• Kim CH
• Kim BK
• Lim YH

• KMID: 2185381
• DOI: http://doi.org/10.4055/jkoa.2012.47.4.316

Abstract

Lipofibromatous hamartoma is a rare tumor of the peripheral nerves which is characterised by an excessive infiltration of the epineurium and perineurium by fibroadipose tissue and very few cases have been described and reported in the literature. Surgical treatments of lipofibromatous hamartoma include partial excision, debulking operation, nerve decompression and so on. We report a case of recurrent lipofibromatous hamartoma of the median nerve that partial excision was done previously but causing secondary carpal tunnel syndrome and a review of the literature regarding the etiology, pathogenesis and surgical management of lipofibromatous hamartoma.

Keyword

median nerve; lipofibromatous hamartoma; carpal tunnel syndrome

MeSH Terms

Carpal Tunnel Syndrome
Decompression
Hamartoma
Median Nerve
Peripheral Nerves

Figure

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  Figure 1 Magnetic resonance imaging scan showing the case of lipofibromatous hamartoma of the median nerve. (A, B) Low-intensity structures representing thickened nerve fascicles, surrounded by evenly distributed fat, high signal intensity on T1-weighted sequences and low signal intensity on T2-weighted sequences. T1 and T2 axial section at the base of metacarpals shows the typical 'cable-like appearance' (C) T1 coronal section of the wrist demonstrates 'fusiform-like enlargement' of the median nerve surrounded by fat.

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  Figure 2 Clinical photographs. (A) Tumor in the left palm of the patient. (B) Intra-operative view of the enlarged left median nerve with fibroadipose tissue proliferation. (C) Photograph after a partial excision of the mass with epineurolysis and bleeding control.

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  Figure 3 Charateristic histologic findings in lipofibromatous hamartoma (H&E stain, ×20): The mass is composed of large nerve bundles (black arrow) surrounded by intermingled fibrous (A) and adipose tissue (B).

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