Pagonis et al. Journal of Medical Case Reports 2011, 5:552 http://www.jmedicalcasereports.com/content/5/1/552 Page 4 of 5 Figure 4 The flexor tendons and the median and ulnar nerves are identified and protected. the correct diagnosis in 94% of cases [1]. The tumors lie in close approximation to important neurovascular structures and tendons, which makes the operation very demanding. Conclusion It must be realized that not all lipomas of the wrist and hand are diagnosed. Our report emphasizes the hidden dangers of misdiagnosing or altogether missing lipomas in cases with carpal tunnel symptoms. The need for a thorough clinical examination and a sound intra-operative investigation of all anatomical structures involved in the carpal tunnel release opera- tion is of paramount importance. Although treating phy- sicians may consider this type of operation a simple one, a high suspicion index concerning tissue involvement in Figure 5 Reconstruction of the Flexor Policis Longus tendon with an intercalated autograft of Palmaris Longus tendon.