Fatty Infiltration of the Median Nerve

Yeoman, P

doi:10.1302/0301-620x.46b4.737

Cited by 51 publications

(20 citation statements)

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“…Indeed, axial MRI images may reveal pathognomonic serpiginous "cable-like" appearance of a peripheral nerve mass. 16 The etiology and pathogenesis of this lesion remain obscure, and the use of numerous pseudonyms in the literature attests to this confusion (e.g., "intraneural lipoma," 17 " lipofibroma," 18 and "fatty infiltration of the median nerve" 19 ). Indeed, Johnson and Bonfiglio first introduced the term " lipofibromatous hamartoma" (LFH), and it is now considered most appropriate.…”

Section: Discussionmentioning

confidence: 99%

Lipofibromatous Hamartoma of the Palmar Cutaneous Branch of the Median Nerve

Hoellwarth

Goitz

2018

J Hand Microsurg

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Lipofibromatous hamartoma (LFH) is a benign tumor of peripheral nerves, most commonly reported in the median nerve, and often associated with carpal tunnel symptoms. There have been nearly 200 reported cases of LFH in the median nerve, but to the authors' knowledge, this 10-year-old girl represents the first case report involving the palmar cutaneous branch. An excisional biopsy of the mass was performed via a standard midline palmar incision. The tumor was found encapsulating the palmar cutaneous branch, and thus it was sacrificed. The incision healed without issue, but the patient reported numbness in the palm of her hand as was expected. LFH is a benign tumor, although it can cause symptoms due to mass effect. If the diagnosis is uncertain or a patient is symptomatic, excisional biopsy can be performed even if involving a cutaneous nerve.

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Section: Discussionmentioning

confidence: 99%

Lipofibromatous Hamartoma of the Palmar Cutaneous Branch of the Median Nerve

Hoellwarth

Goitz

2018

J Hand Microsurg

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“…The surgical management of lipofibromatous hamartoma is controversial. [14] Recommendations for treatment of this lesion include decompression of carpal tunnel, [12,15,16] decompression and debulking of fibro-fatty sheath, [17] microsurgical dissection of neural elements, [11] and the excision of the involved nerve segment with or without grafting. [5,18,19] In our case, decompression was done by dividing the flexor retinaculum and deep fascia in the lower fourth of the forearm, an epineurotomy and biopsy were performed in the carpal tunnel area, and partial debulking of the mass was done at the base of the index finger for biopsy.…”

Section: Discussionmentioning

confidence: 99%

Lipofibromatous hamartoma of the median nerve: A case report and review of the literature

Patil¹,

Nagle²

2009

Indian J Plast Surg

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A case of lipofibromatous hamartoma of the median nerve in an adult is described in this article. A 33-year-old male presented with tingling, numbness and swelling in the palm of the left non dominant hand that had been present for a few months. Examination revealed that there was fullness in the volar aspect of the wrist and in the inter-thenar area. Another mass was present at the base of the index finger, which appeared to be involving subcutaneous tissues. The clinical diagnosis was carpal tunnel syndrome due to a space occupying tumor mass in the carpal tunnel. On exploration of the carpal tunnel, a large median nerve was seen 4 cm proximal to the wrist crease line and extending distally until it divided into its branches. Another mass was present at the base of the index finger, which was adherent to the skin. The radial digital nerve of the index finger was normal in size. For the enlarged nerve, an epineurotomy was performed and a biopsy was taken. Another biopsy was taken from the distal mass. His postoperative period was uneventful. In July 2004, at the end of 5 years, the patient had no symptoms and the size of the tumor had not increased.

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“…Surgical decompression by dividing the ret- inaculum and fascia or carpal tunnel with or without decreasing the bulk of the tumor has given good results. 3,[5][6][7][8][9]12,13,15 For tumors that are well encapsulated or that can be separated from the neural elements, resection of the tumor has also given good results. 2,4,16,19 In contrast, radical resection with a portion of the nerve can be devastating in terms of motor and sensory function.…”

Section: Discussionmentioning

confidence: 99%