tailieunhanh - Báo cáo y học: "Fibrolipomatous hamartoma in the median nerve in the arm - an unusual location but with MR imaging characteristics: a case report"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Fibrolipomatous hamartoma in the median nerve in the arm - an unusual location but with MR imaging characteristics: a case report. | Nilsson et al. Journal of Brachial Plexus and Peripheral Nerve Injury 2010 5 1 http content 5 1 1 JOURNAL OF BRACHIAL PLEXUS AND PERIPHERAL NERVE INJURY CASE REPORT Open Access Fibrolipomatous hamartoma in the median nerve in the arm - an unusual location but with MR imaging characteristics a case report Jessica Nilsson1 Kristina Sandberg1 Lars B Dahlin1 Nina Vendel2 Eva Balslev3 Lone Larsen4 Niels Soe Nielsen5 Abstract Fibrolipomatous hamartoma of the median nerve are usually located distally in the forearm and may have characteristic features on MR imaging. Here we report a patient with an extensive fibrolipomatous hamartoma at an unusual location proximally in the arm where a preoperative MR imaging was pathognomonic and diagnosis was verified by an incisional biopsy. We suggest that MRI should be performed in cases with nerve dysfunction without an obvious cause after a thorough clinical examination. Background The two most common nerve tumours in the upper extremity are Schwannoma and neurofibroma 1 2 . More rare is a fibrolipomatous hamartoma a benign slow-growing mass which is usually located in the median nerve distally in the forearm 3-7 and in its digital branches 1 4 5 . With MR imaging it is not always possible to make a diagnosis of a nerve tumour 2 but the MR imaging characteristics of fibrolipomatous hamartoma are considered to be pathognomonic 3 . In coronal plane the nerve tumour is characterised by serpiginous structures 4 6 thickened nerve fascicles which are surrounded by fat high signal intensity on T1-weighted images low signal intensity on fat-suppressed T2-weighted images 3 . In most of the cases the fat is distributed between the nerve fascicles making the nerve tumour looking like a coaxial cable in the axial plane 3-5 8 9 . Even if the nerve tumour has a characteristic feature on MRI the suspicion of a nerve tumour is not always obvious for the clinician. Here we report a case with obscure clinical symptoms and signs of .