Oral Intraneural Perineurioma. Report of Two Cases

Rocha, Lucio Agostinho; Lopes, Sílvia Maria Paparotto; Santos‐Silva, Alan Roger; Lopes, Márcio Ajudarte; Vargas, Pablo Agustı́n

doi:10.1590/s1807-59322009001000017

Cited by 12 publications

(11 citation statements)

References 4 publications

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“…Among major nerves the ulnar, median and radial nerves of the upper extremities, the peroneal, posterior interosseous and sciatic nerves of the lower extremities, as well as the brachial plexus are most frequently affected [5,6]. While motor and sensorimotor abnormalities as well as denervation, which correlates with muscular atrophy, have been described in lesions affecting major nerves, alleged IPs of non-major (unnamed) nerves, such as in oral mucosa, are reported as asymptomatic [7,[9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…The most detailed reviews on IP were authored by Boyanton et al [5] and Mauerman et al [6], the former group of investigators regarding them neoplasms, the latter group supporting a hyperplastic process as a pathogenetic mechanism. Alleged examples of oral IPs have affected the inferior alveolar nerve [7,8] and non-major nerves of the tongue [5,[9][10][11], lower lip [12] and buccal mucosa [12,13] In one patient with hemifacial hyperplasia, multiple lesions were encountered [13]. An unusual multifocal perineurial proliferation affecting the tongue of a horse with features ''reminiscent of but not identical to IP'' has also been described [14].…”

Section: Introductionmentioning

confidence: 99%

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On Pseudo-Onion Bulb Intraneural Proliferations of the Non-Major Nerves of the Oral Mucosa

Koutlas

Scheithauer

2013

Head and Neck Pathol

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Perineurial cells (PCs) participate in reactive and neoplastic processes, of the latter pure perineurial being intraneural (IP) and soft tissue perineuriomas with oral examples being reported in both. In our review of over 500 peripheral nerve sheath tumors including granular cell tumor, we identified a single ostensible case of IP occurring on the tongue of a 45-year-old African-American male that was characterized by classic perineurial pseudo-onion bulbs (PsOb), proliferating PCs among these PsOb, sclerosis apparently due to long term duration and a plexiform pattern. We have also encountered 37 examples of apparently reactive, hyperplastic or traumatic, PsOb intraneural pseudoperineuriomatous proliferation (IPP) simulating microscopically some of the properties of IP. The majority of the lesions occurred in women and close to 80 % affected the tongue. Three microscopic patterns were appreciated. Type I lesions were those where IPP was seen only focally, type II where it was seen in roughly half of the lesion, and type III where the majority of the lesional tissue or the lesion itself was characterized by IPP. Immunohistochemically, IPP featured PsOb with generally a single layer of PCs decorated by epithelial membrane antigen, glut-1 or claudin-1, and decreased numbers of S-100 positive Schwann cells. The number of axons was not apparently altered. A prominent collagenous intraneural component was occasionally evident among PsOb and the affected nerve featured discontinuous or absent perineurial envelop. While type I and II IPP can be distinguished from IP, the distinction from type III lesions can be problematic. However, the discontinuity of the perineurium of the affected nerve, the spacing and collagenization among PsOb, the limited perineurial cell layer defining the pseudo-onion bulbs, the absence of proliferating PCs between PsObs and the decreasing number of Schwann cells may be of help in the distinction from IP.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

On Pseudo-Onion Bulb Intraneural Proliferations of the Non-Major Nerves of the Oral Mucosa

Koutlas

Scheithauer

2013

Head and Neck Pathol

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“…Twelve tumors of the oral mucosa, including the present patient, have been described in the English literature to date 4,9,15–21 . The histology of oral STP is almost identical to that occurring at other sites 18–20,22 . Although few detailed gross descriptions are available, at least six patients (including the present case) had protruding lesions described as polypoid, 4,17 papular, 9 sessile, 21 and swelling 16 .…”

Section: Discussionmentioning

confidence: 59%

“…4,9,[15][16][17][18][19][20][21] The histology of oral STP is almost identical to that occurring at other sites. [18][19][20]22 Although few detailed gross descriptions are available, at least six patients (including the present case) had protruding lesions described as polypoid, 4,17 papular, 9 sessile, 21 and swelling. 16 In addition, most of the STPs arising in the colon and small intestine presented as mucosal polyps.…”

Section: Cd34 Wasmentioning

confidence: 79%

Plexiform perineurioma of the lip: A case report and review of literature

Kawakami¹,

Hirose²,

Kimoto³

et al. 2012

Pathology International

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We describe a plexiform perineurioma, which is an extremely rare variant of soft tissue perineurioma. A 43-year-old Japanese man presented with a painless, well-demarcated, elastic, soft tumor measuring 2.0 × 1.9 cm on the upper lip that had persisted for three years. Microscopically, a plexiform tumor composed of minimally atypical spindle cells with wavy nuclei was located in the lamina propria of the oral mucosa. Tumor cells were concentrically arranged around small vessels and aligned in parallel with delicate collagen fibers on a fibromyxoid background in the hypocellular area. Tumor cells were immunohistochemically positive for EMA, GLUT-1, claudin-1, and CD34 and negative for S-100 protein. The histopathological and immunohistochemical profiles of the excised tumor indicated a diagnosis of plexiform perineurioma. The patient has remained free of recurrence for sixteen months. Intraoral soft tissue perineurioma is rare and two of the four reported plexiform perineuriomas, including that described herein, notably involved the intraoral area. According to previous reports, plexiform perineuriomas largely develop in middle-aged women without a history of type 1 or type 2 neurofibromatosis. The clinical courses of all reported plexiform perineuriomas have been benign.

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“…It characteristically causes progressive loss of motor function [4]. However, intraneural perineuriomas have been shown to arise in small, unnamed nerves in the oral cavity [2,3,5,6].…”

Section: Introductionmentioning

confidence: 99%

Intraoral Pseudo-Onion Bulb Intraneural Proliferations in a Patient with Hemimandibular Hyperplasia: A Case Report and Review of the Literature

Vargo

Potluri

Bauer

et al. 2016

Head and Neck Pathol

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This report and review of the literature describes a case of benign intraoral lesions of perineurial origin in a patient with symptomatic hemimandibular hyperplasia causing partial denture soreness. Perineuriomas are a benign peripheral nerve sheath tumor composed of perineurial cells. Intraoral perineuriomas are an extremely rare entity. Two main types of perineuriomas have been described: intraneural and extraneural perineuriomas. A third, similar entity, called an intraneural pseudoperineuriomatous proliferation, has recently been proposed in the literature as a separate and distinctive diagnosis. This report describes the histologic and clinical presentation of intraneural pseudoperineuriomatous proliferations in a patient with hemimandibular hyperplasia.

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Oral Intraneural Perineurioma. Report of Two Cases

Cited by 12 publications

References 4 publications

On Pseudo-Onion Bulb Intraneural Proliferations of the Non-Major Nerves of the Oral Mucosa

On Pseudo-Onion Bulb Intraneural Proliferations of the Non-Major Nerves of the Oral Mucosa

Plexiform perineurioma of the lip: A case report and review of literature

Intraoral Pseudo-Onion Bulb Intraneural Proliferations in a Patient with Hemimandibular Hyperplasia: A Case Report and Review of the Literature

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