Adipose lesions of nerve: the need for a modified classification

Clinical article

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  • 1 Departments of Neurologic Surgery,
  • | 2 Laboratory Medicine and Pathology,
  • | 3 Radiology, and
  • | 4 Orthopedics, Mayo Clinic, Rochester, Minnesota
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Object

Adipose lesions of nerve are rare and poorly understood. Their current classification, although not universally accepted, generally includes lipomatosis of nerve with or without localized macrodactyly, and intra- as well as extraneural lipoma. The authors believe that the spectrum of these lesions and their interrelationships are not currently appreciated. They propose an adaptation to the existing framework to illustrate the expanding spectrum of adipose lesions of nerve by considering lipomatosis and lipoma singly or in combination.

Methods

Fourteen representative cases are presented to demonstrate not only the intraneural and extraneural examples of lipomatosis and lipoma, but also their anatomical combinations.

Results

Based on the cases presented and a careful literature review, a conceptual approach to the classification of adipose lesions of nerve is generated. This approach incorporates the 2 essential lesions, lipomatosis of nerve and lipoma, in both their intra- and extraneural forms. This permits expansion to encompass combinations.

Conclusions

To press the concept that adipose tumors of nerve are a broad but interrelated spectrum of lesions, the authors propose modification of the present classification system. This approach provides an orderly platform for progress, reflects understanding of these interrelated lesions, and facilitates optimal treatment by distinguishing resectable from nonresectable components.

Abbreviations used in this paper:

AFIP = Armed Forces Institute of Pathology; FLH = fibrolipomatous hamartoma; FSE = fast spin echo; LFH = lipofibromatous hamartoma.

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Contributor Notes

Address correspondence to: Robert J. Spinner, M.D., Mayo Clinic, Gonda 8S-214, Rochester, Minnesota 55905. email: spinner.robert@mayo.edu.

Please include this information when citing this paper: published online October 7, 2011; DOI: 10.3171/2011.8.JNS101292.

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