Case Of Lipofibromatous Hamartoma Research Articles

Rare benign median nerve angiogenetic lipofibromatous hamartoma: A case report

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.

Lipofibromatous hamartoma of the median nerve in association with or without macrodactyly

Lipofibromatous hamartoma is a rare tumour-like condition involving the peripheral nerves, particularly the median nerve. It commonly affects the volar aspect of the hands, wrists and forearms of young adults. Most patients present either early with macrodactyly or later with a forearm mass lesion or symptoms consistent with compressive neuropathy of the involved nerve. The clinical and histomorphological findings of five patients with lipofibromatous hamartoma of the median nerve are analysed. The presentation, pathological features and differential diagnosis of neural lipofibromas are discussed along with a brief review of the literature. Of the five cases of lipofibromatous hamartoma, all were seen to involve the median nerve, occurring in four women and one man. Three of these cases had associated macrodactyly which was congenital in two and was seen from childhood in one. Microscopic examination showed fibrofatty tissue surrounding and infiltrating along the epineurium and perineurium. The nerve bundles were splayed apart by the infiltrating adipose tissue. Neural fibrolipomatous hamartoma is a benign condition. Most respond to conservative management with surgical exploration, biopsy and carpal tunnel release to decompress the nerve. Correct diagnosis of this uncommon lesion is important as surgical excision of the lesion may lead to loss of neurological function.

Lipofibromatous hamartoma of median nerve

Lipofibromatous hamartoma is a rare tumour of peripheral nerves which is characterised by an excessive infiltration of the epineurium and perineurium by fibroadipose tissue. To the best of our knowledge, only approximately 88 cases are reported in the literature. We report a rare case of lipofibromatous hamartoma of the median nerve causing secondary carpal tunnel syndrome in a 25 year old patient. This patient was treated conservatively with decompression and biopsy and experienced a complete resolution of symptoms post-operatively. Magnetic resonance imaging may be used to diagnose this lesion as it has very distinctive characteristics. Multiple conditions have been associated with this lesion and a greater understanding of these associations may clarify the pathogenesis. The architecture of the tumour makes excision very challenging and the surgical management remains controversial. A review of the literature regarding the etiology, pathogenesis and surgical management of lipofibromatous hamartoma is included.

Lipofibromatous hamartoma of nerve in the foot

A case of lipofibromatous hamartoma in the foot is described. This tumor-like lesion commonly occurs in the hands, wrists and forearms of young persons. The median nerve is affected in the great majority of cases. Only very rarely, however, is it found in the nerves of the foot. It is believed that the present study is the seventh reported case of lipofibromatous hamartoma in the foot, and is the first case reported in Japan. A review shall be made of the six reported cases in the foot.