Case of fibrolipomatous hamartoma

A three-year-old boy was brought to the pediatric emergency department because of persistent inconsolable crying over the past day. Earlier, on the same week he had complained of a discomfort on his left wrist. 

The patient was otherwise healthy and had taken all due vaccinations.   

On examination, a 4-5 cm swelling was detected on the flexor aspect of his left wrist. An associated weakness of the hand was also identified. The boy crying became louder on moving the wrist. 

Carpal tunnel decompression was performed on his left wrist with incisional biopsy of a fusiform swelling in proximity with the median nerve. Histopathological evaluation exhibited thickened serpiginous nerve bundles surrounded by mature fat cell deposits with diffuse fibroblastic proliferation matrix.

After the surgical removal, the boy’s symptoms reduced considerably.