Presentation
Soft tissue mass on the volar side extending from ulna to fourth web space causing neurologic symptoms.
Patient Data
Marked hypertrophy with intervening fat involving the ulnar nerve in the Guyon canal and beyond to the fingers. Note loss of signal on the fat sat sequences and non-enhancement.
Case Discussion
Neural fibrolipoma or fibrolipomatous hamartoma is a rare benign tumor-like lesion which commonly involves the median nerve. Rarely as in this case it involves other nerves including the ulnar and radial and brachial plexus. Clinically, it presents as a soft, slow-growing, fusiform swelling and may be accompanied by pain, redness and diminished sensation. It can present with macrodactyly on the affected side.