Lipofibromatous hamartoma of sciatic nerve: A case report

Khadka, Sulochana; Adhiakri, Prashant; Regmi, Pradeep Raj; Timilsina, Bibek; Thapa, Anupam Singh; Panta, Bhaskar Raj; Bhandari, Sandip

doi:10.1016/j.amsu.2022.104542

Cited by 3 publications

(4 citation statements)

References 14 publications

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“…Although dumbbell tumors in the sciatic notch are known to occur in isolation, lipomas have been reported in patients with LS plexus LN. [12][13][14] In our case, the finding of subtle overgrowth was detected, which led to a targeted inquiry, which revealed findings consistent with an overgrowth syndrome and provided the patient with a definitive answer.…”

Section: Observationsmentioning

confidence: 72%

“…In the LS plexus and sciatic nerve, this can lead to bony changes such as lower limb lengthening, macrodactyly and exostoses, or osteochondromas and ankylosis; soft tissue changes include adipose proliferation, fatty infiltration, and lipomas. 12 , 13 Although nerve territory overgrowth can be dramatic (so-called macrodystrophia lipomatosa), 14 it can also be subtle. As in our case, overgrowth is not always noted by the patient themselves or detected by physicians, especially in obese patients.…”

Section: Discussionmentioning

confidence: 99%

Section: Observationsmentioning

confidence: 99%

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Unrecognized sciatic lipomatosis of the nerve diagnosed by telehealth: illustrative case

Marek,

Spinner,

Spinner

2024

Journal of Neurosurgery: Case Lessons

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BACKGROUND Lipomatosis of the nerve (LN) is a rare congenital hamartoma in which abundant fibroadipose tissue is found within the epineurium of peripheral nerves. It is frequently associated with nerve territory overgrowth affecting bones or soft tissues. The clinicoradiological features are well known and pathognomonic. OBSERVATIONS A 38-year-old female was evaluated via telehealth for worsened sciatica after the resection of a sciatic notch lipoma, after having been evaluated over a decade for symptoms. Virtual physical examination revealed previously unrecognized subtle limb discrepancy (i.e., overgrowth). Although preoperative radiographs were unavailable during the initial evaluation, postoperative magnetic resonance imaging studies showed evidence of sciatic nerve LN. A diagnosis of LN and nerve territory overgrowth was established. LESSONS Despite its limitations, telehealth can be an effective alternative or adjunct to in-person evaluations in making complex diagnoses. Dedicated examination without clinical suspicion can miss subtle findings. An iterative process prompted by a focused history, knowledge of clinical associations, and pattern recognition can facilitate an accurate diagnosis without obvious face-to-face visual clues. In patients with rare disorders, asynchronous evaluation allows in-person visits to be supplemented by subsequent telehealth virtual physical exam findings. This case illustrates how examination via telehealth can be used to effectively diagnose a rare syndrome.

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Section: Observationsmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Unrecognized sciatic lipomatosis of the nerve diagnosed by telehealth: illustrative case

Marek,

Spinner,

Spinner

2024

Journal of Neurosurgery: Case Lessons

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“…The gold standard of investigation is MRI [ 5 ]. The MRI findings are quite pathognomonic, which helps to differentiate from other benign tumors [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Fibrolipomatous Hamartoma Over the Left Forearm and Palm

Giri,

Reddy,

Suba

et al. 2024

jocr

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Introduction: Fibrolipomatous hamartomas are rare congenital benign tumors that can affect the nerves. The symptoms arise due to compression and may require surgical excision. Case Report: A man in his mid-20s suffered swelling over the volar aspect of the left forearm and hand for 4 months. He was symptomatic. A soft, non-tender swelling of size 6 × 4 cm was present over the flexor aspect of the left forearm and palm, with features suggestive of median nerve compression. Magnetic resonance imaging and electromyography were performed. Decompression of the carpal tunnel was performed with debulking of fibrofatty elements and fine dissection of the neural elements. Conclusion: This case report demonstrates a rare fibrolipomatous hamartoma encompassing the median nerve, which required surgical excision. Keywords: Fibrolipomatous hamartoma, median nerve, surgical excision.

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Ultrasound imaging of median nerve neurolipomatosis: literature review and clinical case description

Khalilova,

Druzhinin

2023

Medicinskij alfavit

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Neurolipomatosis is a rare benign tumor of peripheral nerves. The nerves of the upper extremities are more often involved, in most cases, the median nerves in the carpal canal. Children and young people suffer mainly. The article describes a case of fibrolipomatous hamarthroma of the median nerve in a 24-year-old patient, the ultrasound image is compared with the results of intraoperative observation. Despite the characteristic clinical and pathomorphological picture of this condition, the issues of diagnosis and differential diagnosis remain relevant. A special role is given to ultrasound as a non-invasive, widespread method of lifetime diagnosis of the condition of peripheral nerves. The median nerve, due to its superficial location, is available for visualization, and understanding the ultrasound semiotics of fibrolipomatous hamartoma will allow timely determination of it at the stage of initial clinical manifestations and avoid unnecessary and aggravating neurological deficits of examination methods such as biopsy.

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Lipofibromatous hamartoma of sciatic nerve: A case report

Cited by 3 publications

References 14 publications

Unrecognized sciatic lipomatosis of the nerve diagnosed by telehealth: illustrative case

Unrecognized sciatic lipomatosis of the nerve diagnosed by telehealth: illustrative case

Fibrolipomatous Hamartoma Over the Left Forearm and Palm

Ultrasound imaging of median nerve neurolipomatosis: literature review and clinical case description

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