Kohyama Sho, Tanaka Toshikazu, Okano Eriko, Yanai Takaji, Ochiai Naoyuki
1 Department of Orthopedic Surgery, Kikkoman General Hospital, Nodashi, Chiba, Japan.
J Hand Surg Asian Pac Vol. 2016 Feb;21(1):116-20. doi: 10.1142/S2424835516720073.
Lipofibromatous hamartoma (LFH) is a rare condition of the peripheral nerves that typically affects the median nerve. To the best of our knowledge, this is the first report of LFH of both, the median and ulnar nerves, at the wrist of a 63-year-old female patient. The patient presented to our hospital with a 40-year history of pain, numbness, and dysesthesia affecting all fingers of her left hand. Atrophy of the thenar muscles and the first dorsal interosseous was observed upon physical examination. Imaging studies and a surgery revealed that the patient's median and ulnar nerves were significantly enlarged, confirming the LFH diagnosis. The patient's dysesthesia and numbness improved after Carpal tunnel and Guyon canal release, and her pinch ability improved after opponensplasty. LFH has been known to be solitary, typically affecting median nerve, but it must be noted that the tumor may affect multiple nerves like in our case.
脂肪纤维瘤性错构瘤(LFH)是一种罕见的周围神经疾病,通常累及正中神经。据我们所知,这是首例关于一名63岁女性患者腕部正中神经和尺神经均发生LFH的报告。该患者因左手所有手指疼痛、麻木和感觉异常长达40年而前来我院就诊。体格检查发现鱼际肌和第一背侧骨间肌萎缩。影像学检查及手术显示,患者的正中神经和尺神经明显增粗,确诊为LFH。腕管和Guyon管松解术后,患者的感觉异常和麻木症状有所改善,对掌成形术后捏力有所改善。已知LFH通常为单发,典型地累及正中神经,但必须注意的是,肿瘤也可能像我们的病例一样累及多条神经。