J Korean Soc Surg Hand.  2013 Dec;18(4):161-166. 10.12790/jkssh.2013.18.4.161.

The Change of Preoperative and Postoperaive Magnetic Resonance Imaging Findings in Lipofibromatous Hamartoma of the Median Nerve

• Choi SS
• Kang HJ
• Kim JW
• Kim KM

• KMID: 1840497
• DOI: http://doi.org/10.12790/jkssh.2013.18.4.161

Abstract

Lipofibromatous hamartoma is a very uncommon, benign tumor that involves diffuse infiltration of peripheral nerves by normal-appearing fibrous and adipose tissues. We repost a rare case of secondary carpal tunnel syndrome due to a lipofibromatous hamartoma of the median nerve with preoperative and postoperative magnetic resonance images.

Keyword

Lipofibromatous hamartoma; Median nerve; Magnetic resonance images

MeSH Terms

Carpal Tunnel Syndrome
Hamartoma*
Magnetic Resonance Imaging*
Median Nerve*
Peripheral Nerves

Figure

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  Fig. 1. Magnetic resonance imaging findings of lipofibromatous hamartoma of the median nerve. (A) Sagittal- and (B) Coronal T2-weighted images showing the “hourglass like” appreance of the enlarged median nerve (arrows). (C) Coronal T1-weighted image showing the “spaghetti-like” appreance. (D) Axial T1 image showing the “coaxial cable like” appreance with displacementof flexor tendons (arrow).

• 

  Fig. 2. Intraoperative photographs. (A) The 12 × 2 × 2 cm fusiform median nerve with fibirofatty tissue is surrounded thick fibrous epineurium that is extended the distal forearm to palm. (B) Carpal tunnel release and epineurectomy were done.

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  Fig. 3. Histopathologic finding. Fibroadipose tissue over-growth outside a nerve fascicle. Fibrofatty infiltration around the nerve fascicles separating the individual nerve bundles (H&E, × 100).

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  Fig. 4. Postoperative magnetic resonance imaging. (A) Axial T1-weighted images showing the clear and enlarged central nerve bundle after median nerve decompression. (B) Coronal T1-weighted image showing preoperative spiral pattern nerve bundle changed straightly.

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