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The Journal of Bone and Joint Surgery (American) 84:432-436 (2002)
© 2002 The Journal of Bone and Joint Surgery, Inc.

Case Report

Fibrolipomatous Hamartoma in the Foot: Magnetic Resonance Imaging and Surgical Treatment

A Report of Two Cases

Akira Ogose, MD, Tetsuo Hotta, MD, Takeshi Higuchi, MD, Naoko Katsumi, MD, Hisao Koda, MD and Hajime Umezu, MD

Investigation performed at Niigata University School of Medicine, Niigata, Japan

Akira Ogose, MD
Tetsuo Hotta, MD
Takeshi Higuchi, MD
Naoko Katsumi, MD
Hisao Koda, MD
Hajime Umezu, MD
Departments of Orthopedic Surgery (A.O., T. Hotta, N.K., and H.K.), Radiology (T. Higuchi), and Pathology (H.U.), Niigata University School of Medicine, Asahimachi 1-751, Niigata 951-8510, Japan. E-mail address for A. Ogose: aogose@med.niigata-u.ac.jp

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.


   Introduction
 
Fibrolipomatous hamartoma, also designated as neural fibrolipoma or lipofibromatous hamartoma, is an anomalous growth of fibroadipose tissue of the peripheral nerve sheath. Some cases are associated with macrodactyly. This disorder usually affects nerves in the upper extremities, most commonly the median nerve1-3. Involvement of other nerves is rare.

Magnetic resonance imaging of this disorder is diagnostic, obviating the need for biopsy4-6. The unique longitudinally oriented, cylindrical regions of signal void are thought to represent nerve fascicles with perineural fibrosis. However, this speculation has not been proven because radical excision of the affected nerve is usually impossible. Treatment of this disorder is controversial. Severe motor and sensory deficits have been reported after attempted surgical excision3.

We report two unusual cases of fibrolipomatous hamartoma of the foot, with emphasis on preoperative diagnosis by magnetic resonance imaging and successful surgical treatment. Comparison between the histological specimens and the magnetic resonance . . . [Full Text of this Article]


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A. P. Toms, D. Anastakis, R. R. Bleakney, and T. J. Marshall
Lipofibromatous hamartoma of the upper extremity: a review of the radiologic findings for 15 patients.
Am. J. Roentgenol., March 1, 2006; 186(3): 805 - 811.
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