Median Nerve Fibrolipomatous Hamartoma: Case Report

Abstract

Fibrolipomatous hamartoma of the nerve is a rare, benign, and congenital peripheral nerve tumor. A case with symptoms of carpal tunnel syndrome due to median nerve fibrolipoma were presented. The patient was a 31 years old male and his right side was affected. There was numbness in the 1st, 2nd and 3rd fingers and radial side of the 4th finger, pain awakening from sleep at night, and thenar atrophy. His complaints have been present for four years and have progressed in the last six months. Electromyography, right hand ultrasonography and magnetic resonance imaging (MRI) were performed on the patient. In the hand MRI, a lesion involving the median nerve and giving a cable appearance was observed at the wrist level. During the operation, the median nerve was relaxed throughout the mass and some of the fatty tissue around the nerve was excised. Biopsy findings were compatible with fibrolipomatous hamartoma.

Özet

Sinirin fibrolipomatöz hamartomu, nadir görülen, iyi huylu, konjenital periferik sinir tümörüdür. Median sinir fibrolipomuna bağlı karpal tünel sendromu belirtileri olan olgu sunuldu. Otuz bir yaşında erkek hasta son dört yıldır sağ elinde ortaya çıkan, son altı ayda ilerleyen, 1,2,3,4. parmağın radial taraf yarısında uyuşma, gece uykudan uyandıran ağrı ve uyuşukluk hissi ile başvurdu. Hastaya elektromiyografi, ultrasonografi ve sağ el manyetik rezonans görüntüleme (MRG) yapıldı. El MRG’sinde, median siniri tutan ve kablo görünümü veren lezyon izlendi. Operasyona alınan hastaya kitle boyunca median sinire gevşetme ve sinirin çevre-sindeki yağlı dokunun bir kısmına eksizyon yapıldı. Biyopsi bulguları fibrolipomatöz hamartomu ile uyumluydu.

Keywords: Fibrolipomatöz hamartom, karpal tunel sendromu, median sinir, MRG, tümör