Skeletal Radiology

, Volume 35, Issue 3, pp 180–184 | Cite as

Lipomatosis of the sciatic nerve: typical and atypical MRI features

  • Bernadette Zhi Ying Wong
  • Kimberly K. Amrami
  • Doris E. Wenger
  • P. James B. Dyck
  • Bernd W. Scheithauer
  • Robert J. Spinner
Case Report


Lipomatosis of nerve, also known as fibrolipomatous hamartoma, is a rare condition of nerve, usually affecting the median nerve. The MRI appearance is characteristic. We describe two cases of lipomatosis of nerve involving the sciatic nerve, an extremely unusual location for this lesion, in patients with sciatic neuropathy. These cases share the typical features previously described in the literature for other nerves, but also contain atypical features not previously highlighted, relating to the variability in distribution and extent of the fatty deposition. Recognition of the MRI appearance of this entity is important in order to avoid unnecessary attempts at surgical resection of this lesion.


Lipomatosis of nerve Fibrolipomatous hamartoma Sciatic nerve Macrodystrophia lipomatosa MRI 


  1. 1.
    Fletcher CDF, Unni KK, Mertens F, editors. World health organization classification of tumours. Pathology and genetics of tumours of soft tissue and bone. Lyon: IARC Press; 2002. pp. 24–5Google Scholar
  2. 2.
    Khanna G, Sundaram M, Rotman M, Janney CG. Fibrolipomatous hamartoma of the nerve. Orthopedics 2001;24:919–20Google Scholar
  3. 3.
    Silverman TA, Enzinger FM. Fibrolipomatous hamartoma of nerve: a clinicopathologic analysis of 26 cases. Am J Surg Pathol 1985;9:7–14PubMedCrossRefGoogle Scholar
  4. 4.
    Langa V, Posner MA, Steiner GE. Lipofibroma of the median nerve: a report of two cases. J Hand Surg (Br) 1987;12:221–3CrossRefGoogle Scholar
  5. 5.
    Amadio PC, Reiman HM, Dobyns JH. Fibrolipomatous hamartoma of nerve. J Hand Surg (Am) 1988;13:67–75Google Scholar
  6. 6.
    Wang Y-C, Jeng C-M, Marcantonio DR, Resnick D. Macrodystrophia lipomatosa. MR imaging in three patients. Clin Imaging 1997;21:323–7CrossRefPubMedGoogle Scholar
  7. 7.
    Marom EM, Helms CA. Fibrolipomatous hamartoma: pathognomonic on MR imaging. Skeletal Radiol 1999;28:260–4CrossRefPubMedGoogle Scholar
  8. 8.
    De Maeseneer M, Jaovisidha S, Lenchik L, Witte D, Schweitzer ME, Sartoris DJ, Resnick D. Fibrolipomatous hamartoma: MR imaging findings. Skeletal Radiol 1997;26:155–60CrossRefPubMedGoogle Scholar
  9. 9.
    Drut R. Ossifying fibrolipomatous hamartoma of the ulnar nerve. Pediatr Pathol 1988;8:179–84PubMedCrossRefGoogle Scholar
  10. 10.
    Jacob RA, Buchino JJ. Lipofibroma of the superficial branch of the radial nerve. J Hand Surg (Am) 1989;14:704–6CrossRefGoogle Scholar
  11. 11.
    Oleaga L, Florencio MR, Ereno C, Grande J, Terrones J, Legorburu A, Grande D. Fibrolipomatous hamartoma of the radial nerve: MR imaging findings. Skeletal Radiol 1995;24:559–61CrossRefPubMedGoogle Scholar
  12. 12.
    Price AJ, Compson JP, Calonje E. Fibrolipomatous hamartoma of nerve arising in the brachial plexus. J Hand Surg (Br) 1995;20:16–8CrossRefGoogle Scholar
  13. 13.
    Bibbo C, Warren AM. Fibrolipomatous hamartoma of nerve. J Foot Ankle Surg 1994;33:65–70Google Scholar
  14. 14.
    Berti E, Roncaroli F. Fibrolipomatous hamartoma of cranial nerve. Histopathology 1994;24:391–2PubMedCrossRefGoogle Scholar
  15. 15.
    Boren WL, Henry RE Jr, Wintch K. MR diagnosis of fibrolipomatous hamartoma of nerve: association with nerve territory-oriented macrodactyly (and macrodystrophia lipomatosa). Skeletal Radiol 1995;24:296–7CrossRefPubMedGoogle Scholar
  16. 16.
    Van Breuseghem I, Sciot R, Pans S, Geusens E, Brys P, De Wever I. Fibrolipomatous hamartoma in the foot: atypical MR imaging findings. Skeletal Radiol 2003;32:651–5CrossRefPubMedGoogle Scholar
  17. 17.
    Saifuddin A. Imaging tumours of the brachial plexus. Skeletal Radiol 2003;32:375–87CrossRefPubMedGoogle Scholar
  18. 18.
    Louis DS, Hankin FM, Greene TL, Dick HM. Lipofibroma of the median nerve: long term follow-up of four cases. J Hand Surg (Am) 1985;10:403–8Google Scholar

Copyright information

© ISS 2005

Authors and Affiliations

  • Bernadette Zhi Ying Wong
    • 1
    • 2
  • Kimberly K. Amrami
    • 3
  • Doris E. Wenger
    • 3
  • P. James B. Dyck
    • 4
  • Bernd W. Scheithauer
    • 5
  • Robert J. Spinner
    • 6
    • 7
  1. 1.Mayo Clinic School of MedicineRochesterUSA
  2. 2.Royal Free and University College Medical SchoolUniversity College LondonLondonUK
  3. 3.Department of RadiologyMayo ClinicRochesterUSA
  4. 4.Department of NeurologyMayo ClinicRochesterUSA
  5. 5.Department of PathologyMayo ClinicRochesterUSA
  6. 6.Department of Neurologic SurgeryMayo ClinicRochesterUSA
  7. 7.Department of OrthopedicsMayo ClinicRochesterUSA

Personalised recommendations