Details
23-year-old woman with a mass involving left median nerve since age 6. She has had multiple surgeries and recurrences. Specimen is from most recent recurrence.
There are 2 lesions. In the lower aspect of the slide is a lipofibromatous hamartoma of nerve, an increase in fibrofatty tissue infiltrating and surrounding nerves. This usually presents in childhood, sometimes congenitally, and typically involves the median nerve as a sausage-shaped mass. Treatment is generally surgical debulking for symptom control but nerve damage can be a complication.
In the upper aspect of the slide, there is a traumatic neuroma, likely from repeated surgeries. Microscopically, this appears as an irregular proliferation of nerve fascicles embedded in a fibrotic perineurium.