Use of Ultra-high-frequency Ultrasound on Diagnosis and Management of Lipofibromatous Hamartoma: A Technical Report.

Daniel Boczar,Steven R Clendenen,Stephen D Trigg,Antonio J Forte,Luiza P Serrano

doi:10.7759/cureus.5808

Daniel Boczar, Steven R Clendenen + Show 3 more

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https://doi.org/10.7759/cureus.5808

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Abstract

Lipofibromatous hamartoma (LFH) is a rare, benign tumor found in the peripheral nerves which is challenging to diagnose. We present a case report of the use of ultra-high-frequency ultrasound (UHFUS) on a patient with an LFH to provide valuable information not available on other imaging modalities regarding tumor invasion of the nerve fascicles.

Highlights

Lipofibromatous hamartoma (LFH) is a rare, benign peripheral nerve tumor that most commonly affects the median nerve but can occur in other peripheral nerves [1,2,3]
Lipofibromatous hamartoma (LFH) is a rare, benign tumor found in the peripheral nerves which is challenging to diagnose
We present a case report of the use of ultra-high-frequency ultrasound (UHFUS) on a patient with an LFH to provide valuable information not available on other imaging modalities regarding tumor invasion of the nerve fascicles

Summary

Introduction

Lipofibromatous hamartoma (LFH) is a rare, benign peripheral nerve tumor that most commonly affects the median nerve but can occur in other peripheral nerves [1,2,3]. A 27-year-old woman presented complaining about soft tissue swelling on the volar surface of her left wrist that had been present for over six years She occasionally experienced paresthesia and numbness around the swollen area. The patient complained of progressive sensory disturbance with increasing pain which occurred along the distribution of the median nerve. Both Phalen’s test and Tinel’s sign were positive, indicating carpal tunnel syndrome. UHFUS exam was performed on the affected left distal median nerve at the wrist with the Vevo MD ultrasound device (FUJIFILM Visual Sonics, Amsterdam, the Netherlands) using a 70 MHz linear array transducer. UHFUS of the patient's left forearm demonstrated a normalappearing median nerve (Figure 4). UHFUS of the patient's right wrist shows a normal median nerve (Figure 4)

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