A Case of Reconstruction Using a Nerve Conduit After Total Resection of Digital Nerve Lipomatosis

TL;DR

A rare case of nerve lipomatosis in a young woman was successfully treated with nerve resection and reconstruction using a nerve conduit.

Contribution

This case highlights the successful use of a nerve conduit for reconstruction after total resection of digital nerve lipomatosis.

Findings

Total excision of the fatty tumor and affected nerve was followed by successful nerve reconstruction using a nerve conduit.

Histopathological examination confirmed the diagnosis of fibrolipomatous hamartoma with no progression at three-year follow-up.

Sensory function improved and range of motion remained normal after the procedure.

Abstract

Lipomatosis of the nerve in the digital nerve is extremely rare. We report a case of lipomatosis of the nerve in the digital nerve on the ulnar side of the ring finger in a 20-year-old female. The patient presented with neurological symptoms, including pain and numbness. Magnetic resonance imaging revealed a fatty lesion on the ulnar side of the left ring finger, and biopsy revealed adipose tissue and fibrous stroma, but no definitive diagnosis was made. Surgical treatment consisted of total excision of the fatty tumor along with the affected nerve, followed by nerve reconstruction using a nerve conduit, as decompression or partial resection was not feasible. Histopathological examination confirmed the diagnosis of fibrolipomatous hamartoma. No progression or new lesions were detected at three‑year follow‑up. Sensory function on the ulnar side of the ring finger improved, and range of motion remained normal. When encountering a fatty soft tissue tumor around a nerve, the possibility of lipomatosis of the nerve should be considered, and surgical planning should take into account the potential need for nerve resection and reconstruction.

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