Abstract
Fibrolipomatous hamartoma (FLH) of the nerve (also known as perineural lipoma, neural fibrolipoma, or lipomatosis of the nerve) is a well-known, rare benign lesion that can affect any peripheral nerve, resulting in significant enlargement of the involved nerve with fibrofatty infiltration. Although it is most commonly involving the median nerve, other peripheral nerves can be also involved. Being familiar with the pathognomonic characteristics on different imaging modalities and the association of this entity with macrodactyly help reach the diagnosis, avoid putting the patient at risk of an invasive procedure, and can guide management. We present to you a rare case of a FLH of the median nerve that was diagnosed on MRI of an adult female who presented with carpal tunnel syndrome (CTS) and progressive swelling of the right hand and wrist.