Lipofibromatous Hamartoma of the Palmar Cutaneous Branch of the Median Nerve

Abstract Background 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. Methods 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. Results The incision healed without issue, but the patient reported numbness in the palm of her hand as was expected. Conclusion 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.

[1]  H. Kini,et al.  Lipofibromatous Hamartoma of the Median Nerve in Association with or without Macrodactyly. , 2014, Turk patoloji dergisi.

[2]  R. Kanthan,et al.  Fibrolipomatous hamartoma of the median nerve: A cause of acute bilateral carpal tunnel syndrome in a three-year-old child: A case report and comprehensive literature review , 2014, Plastic surgery.

[3]  Youssef Tahiri,et al.  Lipofibromatous hamartoma of the median nerve: a comprehensive review and systematic approach to evaluation, diagnosis, and treatment. , 2013, The Journal of hand surgery.

[4]  J. Ha,et al.  Fibrolipomatous hamartoma of the median nerve in the elbow: a case report. , 2012, The Ochsner journal.

[5]  Melissa C. Price,et al.  Preserved neurologic function following intraneural fascicular dissection and nerve graft for digital and median nerve lipofibromatous hamartoma. , 2010, Plastic and reconstructive surgery.

[6]  L. Dahlin,et al.  Fibrolipomatous hamartoma in the median nerve in the arm - an unusual location but with MR imaging characteristics: a case report , 2010, Journal of Brachial Plexus and Peripheral Nerve Injury.

[7]  V. Patil,et al.  Lipofibromatous hamartoma of the median nerve: A case report and review of the literature , 2009, Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India.

[8]  D. Nardella,et al.  Lipofibromatous hamartoma of the median nerve. Three case reports. , 2009, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[9]  L. Dahlin,et al.  Magnetic resonance imaging of peripheral nerve tumours in the upper extremity , 2009, Scandinavian journal of plastic and reconstructive surgery and hand surgery.

[10]  D. Sartoris,et al.  Fibrolipomatous hamartoma: MR imaging findings , 1997, Skeletal Radiology.

[11]  N. Pallua,et al.  Lipofibromatous hamartoma of the median nerve in patients with macrodactyly: diagnosis and treatment of a rare disease causing carpal tunnel syndrome , 2009, Archives of Orthopaedic and Trauma Surgery.

[12]  R. Bains,et al.  Recurrent carpal tunnel syndrome in a child due to fibrolipomatous hamartoma of the median nerve successfully treated by limited excision and decompression. , 2006, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[13]  Hung-Chi Chen,et al.  Lipofibromatous hamartoma of the median nerve with long-term follow-up. , 2005, Chang Gung medical journal.

[14]  M. Al-Qattan Lipofibromatous Hamartoma of the Median Nerve and its Associated Conditions , 2001, Journal of hand surgery.

[15]  C. Helms,et al.  Fibrolipomatous hamartoma: pathognomonic on MR imaging , 1999, Skeletal Radiology.

[16]  L. Warhold,et al.  Lipofibromatous hamartomas of the median nerve. , 1993, The Journal of hand surgery.

[17]  D. Resnick,et al.  Imaging findings in a patient with fibrolipomatous hamartoma of the median nerve. , 1993, AJR. American journal of roentgenology.

[18]  D. Louis,et al.  Lipofibromas of the median nerve: long-term follow-up of four cases. , 1985, The Journal of hand surgery.

[19]  F. Enzinger,et al.  Fibrolipomatous hamartoma of nerve: A clinicopathologic analysis of 26 cases , 1985, The American journal of surgical pathology.

[20]  P. Manák,et al.  [Lipofibromatous hamartoma of the median nerve]. , 1982, Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti.

[21]  G. Frykman,et al.  Peripheral nerve hamartoma with macrodactyly in the hand: Report of three cases and review of the literature. , 1978, The Journal of hand surgery.

[22]  J. I. Kendrick,et al.  Intraneural lipoma of the median nerve; report of two cases. , 1970, Cleveland Clinic quarterly.

[23]  R. Johnson,et al.  Lipofibromatous hamartoma of the median nerve. , 1969, The Journal of bone and joint surgery. American volume.

[24]  N. Rosenberg,et al.  Intraneural lipoma of the median nerve. Report of two cases and review of the literature. , 1969, The Journal of bone and joint surgery. American volume.

[25]  S. Rowland Lipofibroma of the median nerve in the palm. , 1967, The Journal of bone and joint surgery. American volume.

[26]  A. Emmett LIPOMATOUS HAMARTOMA OF THE MEDIAN NERVE IN THE PALM. , 1965, British journal of plastic surgery.

[27]  P. Yeoman FATTY INFILTRATION OF THE MEDIAN NERVE. , 1964, The Journal of bone and joint surgery. British volume.

[28]  D. G. Mason,et al.  Mixed adenoma (hamartoma) on the liver; report of a case. , 1953, Annals of internal medicine.