Neural fibrolipoma

Neural fibrolipoma is a rare benign neoplasm that involves the proliferation of mature adipocytes among nerve bundles. It is also known as fibrolipomatous hamartoma, lipomatosis of nerve, or perineural lipoma.

Etiology

The exact cause of neural fibrolipoma is unknown. However, it is believed to be a congenital condition, meaning it is present at birth. Some researchers suggest that it may be related to an abnormal response to injury.

Clinical Presentation

Neural fibrolipoma typically presents as a slow-growing, painless mass. It most commonly affects the median nerve, but can also involve other peripheral nerves. Symptoms may include numbness, tingling, and weakness in the affected area.

Diagnosis

Diagnosis of neural fibrolipoma is typically made based on clinical presentation and imaging studies. Magnetic resonance imaging (MRI) is the imaging modality of choice. On MRI, neural fibrolipoma appears as a mass with high signal intensity on T1-weighted images and intermediate signal intensity on T2-weighted images. The characteristic feature is the presence of fat interspersed with thickened nerve bundles, giving a "cable-like" appearance.

Treatment

Treatment of neural fibrolipoma is primarily surgical. The goal of surgery is to remove the mass while preserving nerve function. However, complete removal may not be possible due to the intimate association of the tumor with the nerve. In such cases, debulking of the tumor may be performed to relieve symptoms.

Prognosis

The prognosis for neural fibrolipoma is generally good. Although the tumor is benign and does not spread to other parts of the body, it can cause significant morbidity due to nerve compression and associated symptoms. Recurrence after surgery is rare.

See Also

• Neoplasm
• Magnetic resonance imaging
• Peripheral nerve