Fibrolipomatous Hamartoma of the Palm: A Diagnostic Mimicker of Soft Tissue Tumors

Abstract

Fibrolipomatous hamartoma, also known as Neurolipoma or lipomatosis of nerve, is a rare, non-cancerous growth that happens when fibro-fatty tissue grows around peripheral nerves. It most often affects the median nerve and may show up as a soft tissue swelling that slowly gets bigger and is linked to symptoms of compression. It can be hard to make a diagnosis before surgery, especially with cytology, because the signs are similar to those of other benign spindle cell lesions. We describe a case involving a 48-year-old male who exhibited a 3-month history of swelling in the right hand, accompanied by numbness and tenderness. A clinical exam showed a swelling. Fine needle aspiration cytology revealed aggregates of small, benign spindle cells, indicating a diagnosis of benign spindle cell lesion. Histopathological analysis of the excised specimen demonstrated fibro-fatty tissue containing distinctive nerve bundles situated within fibrocollagenous stroma and adipose tissue, indicative of Fibrolipomatous hamartoma. The case is presented due to its rarity, diagnostic challenges in cytology, and distinctive histopathological characteristics.