Fibrolipomatous Hamartoma of the Median Nerve: A Case Report

Fibrolipomatous hamartoma, also known as fibrofatty overgrowth or perineural lipoma, or neural fibrolipoma, is a rare, benign, congenital lesion that occurs due to an abnormal overgrowth of mature fat and fibroblasts within the perineurium. This leads to the expansion of the nerve and separation of fascicles. It is more commonly observed in the median nerve at the wrist or hand level. Here, the authors presented the case of a 32-year-old female patient, who complained of swelling in the left wrist region for the past two years. The swelling gradually increased in size over one year and caused pain and paresthesia. Magnetic Resonance Imaging (MRI) of the left wrist revealed fibrolipomatous hamartoma of the median nerve. Surgical management was advised, but the patient declined and opted for conservative treatment for two months. Knowledge of this rare condition helps radiologists make an accurate diagnosis and may eliminate the need for invasive biopsy.