Peripheral nerve, Lipofibromatous hamartoma of nerve & traumatic neuroma [LMP19230]

LMP19230 Thumbnail
View the Zoomify Image
Image Details
Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Neoplasia
Diagnosis: 
Lipofibromatous hamartoma of nerve & traumatic neuroma
Species: 
Human
Organ System: 
Peripheral Nerve and Skeletal Muscle
Gender: 
Female
Age: 
23 years
Diagnosis Code: 
ICD-10: D36.1
Slide Contributor Information
Gao, A., Kiehl, TR.

Keywords

fibrolipomatous hamartoma, neural fibrolipoma, neurolipomatosis, lipomatosis of nerve

Clinical History

23-year-old woman with a mass involving left median nerve since age 6. She has had multiple surgeries and recurrences. Specimen is from most recent recurrence.

Clinical Discussion

There are 2 lesions. In the lower aspect of the slide is a lipofibromatous hamartoma of nerve, an increase in fibrofatty tissue infiltrating and surrounding nerves. This usually presents in childhood, sometimes congenitally, and typically involves the median nerve as a sausage-shaped mass. Treatment is generally surgical debulking for symptom control but nerve damage can be a complication.

In the upper aspect of the slide, there is a traumatic neuroma, likely from repeated surgeries. Microscopically, this appears as an irregular proliferation of nerve fascicles embedded in a fibrotic perineurium.