Case History: 30-year-old female, increased wrist swelling since birth.
Case History: 30-year-old female presents with painless swelling on volar aspect of right wrist since birth.Swelling gradually increases in size and has become painful in the last five months.
On physical examination, there was atrophy of thenar eminence. No other neurological signs of sensory or motor dysfunction were seen, and no history of trauma.
Figure 1. Longitudinal image shows fusiform enlargement of the nerve with hyperechoic fat interspersed between hypoechoic nerve fascicles.
Figure 2. Axial USG image shows fusiform enlargement of the nerve with hyperechoic fat interspersed between hypoechoic nerve fascicles and no color flow on Doppler images.
Figure 4. Sagittal T2-weighted fast spin echo in the location of palpable mass shows a fusiform mass in the expected location of the median nerve (arrow) with a “spaghetti string” appearance.
Lipofibromatous hamartoma is an uncommon benign lesion that arises due to overgrowth of fibroadipose tissue.
Patients mostly present with soft, slowly enlarging, painless mass on volar aspect of wrist or forearm since infancy.
Management in most cases is conservative. Surgical treatment is only recommended for symptomatic management.