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

Sang Su Choi; Hong Je Kang; Jeong Woo Kim; Kwang Mi Kim

doi:10.12790/jkssh.2013.18.4.161

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Choi, Kang, Kim, and Kim: The Change of Preoperative and Postoperaive Magnetic Resonance Imaging Findings in Lipofibromatous Hamartoma of the Median Nerve

Case Report

J Korean Soc Surg Hand 2013;18(4):161-166.

Published online: 12 December 2013

DOI: https://doi.org/10.12790/jkssh.2013.18.4.161

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

Sang Su Choi¹, Hong Je Kang¹, Jeong Woo Kim¹, Kwang Mi Kim²

¹Department of Orthopedic Surgery, Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Korea

²Department 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.

Received 30 July 201328 October 2013 Accepted 29 October 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.

Keywords: Lipofibromatous hamartoma, Median nerve, Magnetic resonance images

REFERENCES

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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.

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).

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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