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Whether to excise a lipofibroma of the median nerve

A 28-year-old man presented with a lipofibroma of the median nerve of the left hand. We released the carpal tunnel, did a neurolysis, and biopsied of the median nerve together with a distal fasciotomy of the forearm. Two years after the operation, the paraesthesiae of the middle finger had improved but was still present to a lesser degree. Initial considerations about treatment should be directed toward biopsy and alleviation of the compression neuropathy, rather than total excision.