Presentation
Painless swelling in right leg since childhood, progressive enlargement.
Patient Data
There is a fusiform enlargement of the superficial peroneal nerve and its terminal branches with fatty proliferation noted along the anterolateral aspect of the leg, there are serpiginous hypointense structures noted within the lesion in keeping with nerve fascicles surrounded by evenly distributed fat with T1 hyperintense signal and suppressing on STIR.
Visualized muscles of the leg show no denervation edema, atrophy, or localized limb hypertrophy.
Case Discussion
Fibrolipomatous hamartomas are relatively rare fusiform neural mass lesions with thickening of nerve fascicles and abnormal fatty tissue proliferation and present with painless swelling, the imaging findings are pretty characteristic and MRI helps in accurate diagnosis reducing the need for an unnecessary biopsy.
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