Presentation
Soft tissue mass on the volar side extending from ulna to fourth web space causing neurologic symptoms.
Patient Data
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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.