Median Nerve Lipofibrohamartoma: A Treatment Dilemma

Carpal tunnel syndrome is a commonly encountered entity. The tunnel is a narrow space filled with nerves and tendons. Numbness and paraesthesia over the median nerve territory is classical of nerve compression. Pregnancy, hypothyroidism and diabetes are frequent associations, but sometimes no cause can be ascertained. Local pathologies like ganglia and other soft tissue tumors occasionally result in nerve compression.1 A middle aged lady presented with numbness over the thumb, index and middle fingers over her hand. These complaints were present for nearly a year and were more severe in the mornings. She had no history of comorbidities. On examination, there was an ill-defined bulge over her wrist. No definite swelling was palpable. No thenar wasting was present and no sensory weakness was detected. Phalen’s test was positive. The contralateral hand was asymptomatic. A provisional diagnosis of carpal tunnel syndrome was made. The cause, however, was not apparent.