Lipofibromatous hamartoma (LFH) is a rare benign peripheral nerve tumor. The median nerve (MN) is most commonly affected in the upper extremity. We report a case of a 39-year-old male with LFH of the median nerve presented with swelling and symptoms of carpal tunnel syndrome treated successfully with decompression. LFH is reported with various descriptions because of the proliferative nature of its adipocytes and the fibrofatty infiltration within the peripheral nerves. Swelling around the volar aspect of the wrist remains the most frequent presentation of LFH. Surgical decompression without tumor resection can result in symptom improvement. In addition, post-decompression nerve coverage can be a solution to improve the residual hyperesthesia symptoms.

Leprosy (Hansen's disease) is a multisystem, chronic infectious disease that still exists. It is caused by Mycobacterium leprae. Musculoskeletal features are non-consistent and can lead to misdiagnosis and mistreatment. We report the case of a 23-year-old male with the right small finger (RSF) proximal interphalangeal (PIP) joint arthropathy related to leprosy. This was his first encounter with seeking medical advice regarding his condition. The patient was diagnosed and treated with surgical debridement, volar plate arthroplasty for the affected proximal interphalangeal joint, and the recommended multi-drug therapy regimen. The pathological effects of leprosy on the bones and joints have been attributed to several theories, with peripheral nerve neuropathy being the primary cause. Early detection of leprosy is crucial for effective management, preventing further disease transmission, and minimizing the risk of developing complications.