Rare Benign Median Nerve Angiogenetic Lipofibromatous Hamartoma: A Case Report
Abstract
Only a few cases of lipofibromatous hamartoma (LFH) of the median nerve have been described in the literature. LFH is a rare and low growing benign fibro-fatty tumour. It is characterised by the proliferation of mature adipocytes within the epineurium and the perineurium of the peripheral nerves. The median nerve is most frequently affected in the upper extremities. Carpal tunnel syndrome, paraesthesia, numbness and pain are frequently the results of involvement of the median nerve. In presented case, in addition to fibrolipoma, there was also new blood vessel formation noted, which was attributed to the chronicity of the lesion. Diagnosis was missed by ultrasound and MRI due to the presence of blood vessels. Histopathological diagnosis was confirmed. Surgical treatment with carpal tunnel release and neurolysis were performed. This resulted in favourable outcome in 3 months.
References
Verma A, Mukherjee M, Paul S, Yadav P, Mittal A, Mishra R, et al. Lipofibromatous hamartoma of median nerve: A review article. Int J Orthop 2021;7(4):845-50.
Marek T, Mahan MA, Carter JM, Amrami KK, Benarroch EE, Spinner RJ. Lipomatosis of nerve and overgrowth: is there a preference for motor (mixed) vs. sensory nerve involvement? Acta Neurochir (Wien) 2019 Apr;161(4):679-84.
Teles AR, Finger G, Schuster MN, Gobbato PL. Peripheral nerve lipoma: Case report of an intraneural lipoma of the median nerve and literature review. Asian J Neurosurg 2016 Oct-Dec;11(4):458. doi: 10.4103/1793-5482.181118.
Marek T, Spinner RJ, Syal A, Wahood W, Mahan MA. Surgical treatment of lipomatosis of nerve: a systematic review. World Neurosurg 2019 Aug;128:587-92.e2.
Walker FO, Cartwright MS, Alter KE, Visser LH, Hobson-Webb LD, Padua L, et al. Indications for neuromuscular ultrasound: Expert opinion and review of the literature. Clin Neurophysiol 2018 Dec;129(12):2658-79.
Marek T, Spinner RJ, Syal A, Mahan MA. Strengthening the association of lipomatosis of nerve and nerve-territory overgrowth: a systematic review. J Neurosurg 2019 Mar 29;132(4):1286-94.
Slouma M, Zarrouk Z, Maatoug F, Dhahri R, Amorri W, Gharsallah I, et al. Fibrolipoma of the median nerve: an overview. Curr Rheumatol Rev 2022;18(4):298-304.
Walker FO, Cartwright MS, Alter KE, Visser LH, Hobson-Webb LD, Padua L, et al. Indications for neuromuscular ultrasound: Expert opinion and review of the literature. Clin Neurophysiol 2018 Dec 1;129(12):2658-79.
Willinger ML, Henig A, Intravia JM, Ramirez DC, Edelman MC, Kenan S. Neurolipoma of the digit. Hum Path Rep 2023 Mar 1;31:300685. doi: 10.1016/j.hpr.2022.300685.
Elbayer AM, Alharami S, Elhessy AH. Lipofibromatous hamartoma of the median nerve: a case report. Cureus 2023 Jan 8;15(1):e33516. doi: 10.7759/cureus.33516.
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).