Neural fibrolipoma is an overgrowth of fibro-fatty tissue along a nerve trunk that often leads to nerve compression.[1] These only occur in the extremities, and often affect the median nerve. They are rare, very slow-growing, and their origin is unknown.[2] It is believed that they may begin growth in response to trauma. They are not encapsulated by any sort of covering or sheath around the growth itself, as opposed to other cysts beneath the skin that often are. This means there are loosely defined margins of this lipoma. Despite this, they are known to be benign. Neural fibrolipomas are often more firm and tough to the touch than other lipomas. They are slightly mobile under the skin, and compress with pressure.
Neural fibrolipomas are often characterized by a mass under the skin accompanied with sensory deficit in the same area or a painful sensation. There is often loss of motor function in the hand as well. These lipomas are almost exclusively found in people under 30 years old.[3] The mass is made of fibro-fatty tissue that begins encroaches on a nerve. Surgery is often needed to relieve pressure. Some common nerves that are affected are the median, ulnar, radial, perineal, and brachial plexus. Macrodactyly occurs in around two thirds of cases.[4] Taking a biopsy of the mass is not necessary because these are distinct enough to make a confident diagnosis only from the use of medical imaging, like an MRI. However, if a biopsy is taken, it will show an abundance of mature fat cells surrounded by fibrous connective tissue.[5] Neural fibrolipomas are often associated with carpal tunnel syndrome, due to both of their correlation with the median nerve. To diagnose this as a neural fibrolipoma, Tinel's sign and the Phalen maneuver are used to show signs of nerve sensitivity and distress on the median nerve. This, alongside imaging, can accurately diagnose these rare growths.
Treatmentedit
Surgery is often needed to remove the neural fibrolipoma. The surgeon often treats the mass as if it is carpal tunnel syndrome and does a carpal tunnel release.[6] This surgery is paired with neurolysis and a partial excision of the neural fibrolipoma. In some cases, an entire excision may be possible. The surgeon would then begin by decompressing the nerve, and then working to excise the fatty growth, which is easily distinguishable from the nerve. Because of surgery in such close proximity to the median nerve, permanent sensory or motor dysfunction can occur, so surgery is not always the suggested mode of treatment.
^Kim, You Jeong; Kim, Si-Yong; Kang, Seok Jin; Kim, Gyoung Moon (2005-09-01). "Neural fibrolipoma". Journal of the American Academy of Dermatology. 53 (3): 527–528. doi:10.1016/j.jaad.2005.01.122. ISSN 0190-9622. PMID 16112370.
^Ulrich, Dietmar; Ulrich, Franziska; Schroeder, Michael; Pallua, Norbert (2008-07-10). "Lipofibromatous hamartoma of the median nerve in patients with macrodactyly: diagnosis and treatment of a rare disease causing carpal tunnel syndrome". Archives of Orthopaedic and Trauma Surgery. 129 (9): 1219–1224. doi:10.1007/s00402-008-0695-6. ISSN 0936-8051. PMID 18615252. S2CID 29699976.
^Tahiri, Youssef; Xu, Liqin; Kanevsky, Jonathan; Luc, Mario (2013-10-01). "Lipofibromatous Hamartoma of the Median Nerve: A Comprehensive Review and Systematic Approach to Evaluation, Diagnosis, and Treatment". The Journal of Hand Surgery. 38 (10): 2055–2067. doi:10.1016/j.jhsa.2013.03.022. ISSN 0363-5023. PMID 23684521.
^Louaste, Jamal; Zejjari, Hassan; Chkoura, Mohamed; Houmadi, Aziz; Rachid, Khalid (2011). "Carpal tunnel syndrome due to fibrolipomatous hamartoma of the median nerve". Hand (New York, N.Y.). 6 (1): 76–79. doi:10.1007/s11552-010-9290-8. ISSN 1558-9447. PMC3041878. PMID 22379443.
^"Neural Fibrolipoma". Surgical Pathology Criteria - Stanford University School of Medicine. Retrieved 2021-04-06.
January 01, 1970
neural, fibrolipoma, overgrowth, fibro, fatty, tissue, along, nerve, trunk, that, often, leads, nerve, compression, these, only, occur, extremities, often, affect, median, nerve, they, rare, very, slow, growing, their, origin, unknown, believed, that, they, be. Neural fibrolipoma is an overgrowth of fibro fatty tissue along a nerve trunk that often leads to nerve compression 1 These only occur in the extremities and often affect the median nerve They are rare very slow growing and their origin is unknown 2 It is believed that they may begin growth in response to trauma They are not encapsulated by any sort of covering or sheath around the growth itself as opposed to other cysts beneath the skin that often are This means there are loosely defined margins of this lipoma Despite this they are known to be benign Neural fibrolipomas are often more firm and tough to the touch than other lipomas They are slightly mobile under the skin and compress with pressure Contents 1 Diagnosis 2 Treatment 3 Other names 4 See also 5 ReferencesDiagnosis editNeural fibrolipomas are often characterized by a mass under the skin accompanied with sensory deficit in the same area or a painful sensation There is often loss of motor function in the hand as well These lipomas are almost exclusively found in people under 30 years old 3 The mass is made of fibro fatty tissue that begins encroaches on a nerve Surgery is often needed to relieve pressure Some common nerves that are affected are the median ulnar radial perineal and brachial plexus Macrodactyly occurs in around two thirds of cases 4 Taking a biopsy of the mass is not necessary because these are distinct enough to make a confident diagnosis only from the use of medical imaging like an MRI However if a biopsy is taken it will show an abundance of mature fat cells surrounded by fibrous connective tissue 5 Neural fibrolipomas are often associated with carpal tunnel syndrome due to both of their correlation with the median nerve To diagnose this as a neural fibrolipoma Tinel s sign and the Phalen maneuver are used to show signs of nerve sensitivity and distress on the median nerve This alongside imaging can accurately diagnose these rare growths Treatment editSurgery is often needed to remove the neural fibrolipoma The surgeon often treats the mass as if it is carpal tunnel syndrome and does a carpal tunnel release 6 This surgery is paired with neurolysis and a partial excision of the neural fibrolipoma In some cases an entire excision may be possible The surgeon would then begin by decompressing the nerve and then working to excise the fatty growth which is easily distinguishable from the nerve Because of surgery in such close proximity to the median nerve permanent sensory or motor dysfunction can occur so surgery is not always the suggested mode of treatment Other names editNeural lipofibromatous hamartoma Fibrolipomatous hamartoma of the nerve Lipomatosis of the nerve Fibrolipomatosis of the nerve Neurolipomatosis 7 See also editLipoma Skin lesion List of cutaneous conditionsReferences edit James William Berger Timothy Elston Dirk 2006 Andrews Diseases of the Skin Clinical Dermatology 10th ed Philadelphia Saunders Elsevier ISBN 9780721629216 OCLC 62736861 Kim You Jeong Kim Si Yong Kang Seok Jin Kim Gyoung Moon 2005 09 01 Neural fibrolipoma Journal of the American Academy of Dermatology 53 3 527 528 doi 10 1016 j jaad 2005 01 122 ISSN 0190 9622 PMID 16112370 Neural Fibrolipoma WebPathology Retrieved 2023 08 16 Ulrich Dietmar Ulrich Franziska Schroeder Michael Pallua Norbert 2008 07 10 Lipofibromatous hamartoma of the median nerve in patients with macrodactyly diagnosis and treatment of a rare disease causing carpal tunnel syndrome Archives of Orthopaedic and Trauma Surgery 129 9 1219 1224 doi 10 1007 s00402 008 0695 6 ISSN 0936 8051 PMID 18615252 S2CID 29699976 Tahiri Youssef Xu Liqin Kanevsky Jonathan Luc Mario 2013 10 01 Lipofibromatous Hamartoma of the Median Nerve A Comprehensive Review and Systematic Approach to Evaluation Diagnosis and Treatment The Journal of Hand Surgery 38 10 2055 2067 doi 10 1016 j jhsa 2013 03 022 ISSN 0363 5023 PMID 23684521 Louaste Jamal Zejjari Hassan Chkoura Mohamed Houmadi Aziz Rachid Khalid 2011 Carpal tunnel syndrome due to fibrolipomatous hamartoma of the median nerve Hand New York N Y 6 1 76 79 doi 10 1007 s11552 010 9290 8 ISSN 1558 9447 PMC 3041878 PMID 22379443 Neural Fibrolipoma Surgical Pathology Criteria Stanford University School of Medicine Retrieved 2021 04 06 Retrieved from https en wikipedia org w index php title Neural fibrolipoma amp oldid 1183440089, wikipedia, wiki, book, books, library,
