Fibrolipomatous Hamartoma of the Median Nerve: Pathognomonic MRI Features, Diagnosis, and Clinical Management
Introduction Fibrolipomatous hamartoma (FLH) is a rare, benign, tumor-like condition characterized by an abnormal proliferation of mature adipose and fibrous tissue within the epineurium and perineurium of peripheral nerves. Among all peripheral nerves, the median nerve at the wrist and palm is by far the most commonly affected site. Although histologically benign, fibrolipomatous hamartoma can cause significant morbidity due to progressive nerve enlargement and secondary compressive neuropathy. From a radiologic perspective, magnetic resonance imaging (MRI) plays a pivotal role in establishing a confident diagnosis, often eliminating the need for biopsy. The imaging appearance of fibrolipomatous hamartoma is so distinctive that it is frequently described as pathognomonic , particularly on T1-weighted sequences. This article provides a comprehensive, literature-based, expert-level review of fibrolipomatous hamartoma, integrating the provided case of a 35-year-old man presenting ...