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Fibrolipomatous hamartoma (FLH) of the nerve is a malformation of the peripheral nerves, typically the median nerve, accompanied by cutaneous changes. Lesions affect the base of the thumb and the fingers. Other names for this unusual condition include perineurial lipoma, neurolipomatosis, and neural fibrolipoma. These investigators studied the clinicopathologic presentation in 13 patients (age range, 7–52) seen at a single institution.
Nearly half of these cases were present at birth and symptoms slowly increased over time. Lesions were lobulated, soft, nonfluctuant, and minimally tender, appearing on the thenar area, the volar aspect of fingers, especially the index and long finger, or both. Seven patients had macrodactyly, one of whom also…