Abstract
Fibrolipomatous hamartomas of the median nerve are rare, benign tumors characterized by the overgrowth of fibro-fatty tissue within the nerve sheath, often leading to nerve compression. This report presents 2 cases: a 33-year-old man with a gradually enlarging wrist mass and a 48-year-old woman, initially diagnosed with De Quervain's tenosynovitis for radial pain, who was found to have an incidental fibrolipomatous hamartoma on MRI. In both cases, MRI played a pivotal role in diagnosis, revealing characteristic features that enabled a definitive, noninvasive diagnosis. Early recognition of these MRI findings is essential for guiding management and preventing unnecessary surgical interventions.