Lipofibromatous hamartomas of the median nerve

Five cases of lipofibromatous hamartoma of the median nerve are reported. The initial onset of symptoms and recognition of a mass occurred in adults in four cases. The fifth patient was an infant when the mass was first noticed, and she also had macrodactyly. Treatment included carpal tunnel release in three patients, one of whom required a second procedure for excision of the mass and sural nerve grafting. Nerve ablation without grafting was performed in the other two patients; one of these patients noticed no sensory or motor deficit after surgery. From this small series we cannot recommend a preferred treatment for these patients; each case must be approached on an individual basis. The diagnosis is best confirmed by biopsy.