JKSSH Journal of the Korean Society for Surgery of the Hand J Korean Soc Surg Hand 1598-3889 2234-0998 The Korean Society for Surgery of the Hand 10.12790/jkssh.2013.18.4.161 jkssh-18-161 Case Report The Change of Preoperative and Postoperaive Magnetic Resonance Imaging Findings in Lipofibromatous Hamartoma of the Median Nerve ChoiSang Su 1 KangHong Je 1 KimJeong Woo 1 KimKwang Mi 2 Department of Orthopedic Surgery, Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Korea Department of Nursing, Chodang University, Muan, Korea Correspondence to: Hong Je Kang Department of Orthopaedic Surgery, Wonkwang University School of Medicine, 460 Iksan-daero, Iksan 570-974, Korea TEL: +82-63-859-1360 FAX: +82-63-852-9329 E-mail: kanghongje@hanmail.net

*This paper was supprted by Wonkwang University in 2013.

 12 2013 12 12 2013 184 161 166 30072013 28102013 29102013 Copyright © 2013 The Korean Society for Surgery of the Hand 2013 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 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 post-operative magnetic resonance images.

 Lipofibromatous hamartoma Median nerve Magnetic resonance images REFERENCES MasonMLProceedings of American Society for Surgery of the Hand: presentation of caseJ Bone Joint Surg Am1953352735 AgarwalSHaaseSCLipofibromatous hamartoma of the median nerveJ Hand Surg Am2013383927 TahiriYXuLKanevskyJLucMLipofibromatous hamartoma of the median nerve: a comprehensive review and systematic approach to evaluation, diagnosis, and treatmentJ Hand Surg Am201338205567 KimCHKimBKLimYHRecurrent lipofibromatous hamartoma of the median nerveJ Korean Orthop Assoc20124731620 ParkIHKimBKSuhKJJeonIHCarpal tunnel syndrome due to lipofibromatous harmatoma of the median nerve: a case reportJ Korean Soc Surg Hand2005107982 Al-QattanMMLipofibromatous hamartoma of the median nerve and its associated conditionsJ Hand Surg Br20012636872 AmadioPCReimanHMDobynsJHLipofibromatous hamartoma of nerveJ Hand Surg Am1988136775 PalettaFXSenayLCJrLipofibromatous hamartoma of median nerve and ulnar nerve: surgical treatmentPlast Reconstr Surg19816891521 ElsaidiGAWieslerERLipofibromatous hamartoma of the median nerve: case presentation of MRI, ultrasound, electrodiagnostic, histologic, and surgical findingsAm J Orthop (Belle Mead NJ)2004335146 NardellaDSohawonSCarlierALipofibromatous hamartoma of the median nerve: three case reportsJ Plast Reconstr Aesthet Surg200962e3147 Figures

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).

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.

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

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.