Oral perineurioma: clinicopathologic features from two cases and review of literature

Silva, Wagner Gomes da; Martínez, Marisol Martínez; Miranda, Águida Maria Menezes Aguiar; Silva, Roberto Bastos; Silveira, Henrique Martins da; Almeida, Oslei Paes de; Pires, Fábio Ramôa

doi:10.1016/j.oooo.2016.09.223

Cited by 13 publications

(10 citation statements)

References 51 publications

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“…In the present study, reactivity for CD57 in the thick myelinated Schwann cells was much more evident than the positivity for NFP in the thin axons. Of interest was also the absence of reactivity for EMA within OPNSTs with spindle cell morphology, eliminating the possibility of a perineurioma altogether with the S-100 positivity observed in all of the lesions ( 3 , 15 ).…”

Section: Discussionmentioning

confidence: 99%

Oral peripheral nerve sheath tumors: A clinicopathological and immunohistochemical study of 32 cases in a Brazilian population

et al. 2017

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BackgroundOral peripheral nerve sheath tumors (OPNSTs) are reactive or neoplastic diseases that develop from proliferation of the nerve itself or their limiting sheaths. Here we describe the clinicopathologic data of OPNSTs observed in a sample of the Brazilian population and evaluate the expression of molecules associated with neural biology to determine their usefulness in the diagnosis.Material and MethodsDescriptive study of cases diagnosed as OPNSTs, from the Pathology Laboratory at the School of Dentistry/ Federal University of Uberlandia, followed by an immunohistochemical study of S-100, CD57, neurofilament protein (NFP) and epithelial membrane antigen (EMA).ResultsOPNSTs comprised 0.27% of all biopsies. There were eight patients with neurofibromas, eight with traumatic neuromas, seven with schwannomas, five with granular cell tumor (GCT), and four with palisaded encapsulated neuromas (PEN). Women were more frequently affected (60.6% of the cases). Tongue and lips prevailed as the most frequent sites. S-100 was reactive in 100% of the cases. Neural fibers evidenced by CD57 reactivity of their Schwann cells were always nested in bundles within neurofibromas and GCT, absent within schwannomas and dispersed within PEN. Reactivity for NFP was limited to axons and then followed the same pattern of CD57, though much less evident. Reactivity for EMA was observed in the capsular tissues and perineurium of nerve fascicles, and absent in parenchymal cells of GCT.ConclusionsThis study showed that OPNSTs are rare, widely benign and often found in tongue and lips. OPNSTs evolve from a common origin to distinct histological patterns, with eventual overlapping in their clinical and morphologic features. The arrangement of reactive residual neural fibers for CD57 can be a useful staining in the differential diagnosis of OPNSTs. Key words:Peripheral nerve sheath tumors. Oral cavity. Differential diagnosis. Immunohistochemistry. CD57 antigens.

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Section: Discussionmentioning

confidence: 99%

Oral peripheral nerve sheath tumors: A clinicopathological and immunohistochemical study of 32 cases in a Brazilian population

et al. 2017

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“…Searching PubMed from 1981 until 2017 revealed 37 patients with oral PNs. Of these, 15 cases were INPN [ 2 – 14 ] including this present case (Table 1 ). Most reported oral INPN lesions were relatively small, and the mean diameter was approximately 2.1 cm (0.75–4.0 cm), including the present case.…”

Section: Discussionmentioning

confidence: 88%

“…In recent years, it has been reported that chromosome 22 abnormality leading to the alteration of tumor suppressor genes that cause clonal proliferation of perineurial cells is a pathogenesis of its development in PN. In other words, cytogenetic changes and chromosomal abnormalities supporting the fact that PN is not a reactive change but a true benign tumor are thought to be the etiology [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, if the partial deletion of chromosome 22 (deletion of the long arm) is confirmed, it can be demonstrated that PN is a tumorous lesion, as reported for other nerve sheath tumors, due to the loss of a tumor suppressor gene. In a recent report, there is a pseudo-perineurioma (PPN) in the oral cavity caused by the proliferation of perineurial cells in the nerve [ 14 ]. This pathogenesis is thought to be associated with reactive lesions such as traumatic stimuli or conventional fibromas.…”

Section: Discussionmentioning

confidence: 99%

“…It is said that INPN occurs in major thick nerves, whereas PPN occurs in a small branch of the nerve. PPN mainly occurs in the tongue and is said to be small in size as compared with INPN [ 14 , 20 ]. However, at present, there is no clear diagnostic criterion between true PN and PPN.…”

Section: Discussionmentioning

confidence: 99%

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Intraosseous intraneural perineurioma derived from the inferior alveolar nerve with an abnormality of chromosome 22 and expression of the BCR-ABL fusion gene: report of a case and review of recent literature

et al. 2018

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BackgroundPerineurioma (PN) is a peripheral nerve disease that primarily develops in the limbs and trunk and very rarely occurs in the oral cavity. PN is classified into two types: intraneural perineurioma (INPN) and soft tissue perineurioma (extraneural perineurioma, ENPN). In this article, we report a patient with mandibular body INPN derived from the perineurium of the inferior alveolar nerve.Case presentationThe patient was a 43-year-old male. He consulted our department for a detailed examination of the right mandibular body. A biopsy was performed at another hospital and he was diagnosed with a schwannoma. At his first visit, hypesthesia extending from the right lower lip to the mental region was recognized and enlargement of the right mandibular canal was confirmed with X-ray CT and MRI. Considering the possibility of future tumor growth, we extirpated the tumor under general anesthesia. Cystic tumor was seen continuously in the inferior alveolar nerve. Immunohistologically, the tumor cells were positive for Glut-1, weakly positive for EMA, and weakly positive for Claudin-1, and the histopathological diagnosis was INPN. In addition, absence of the BCR region of chromosome 22 and expression of the BCR-ABL fusion gene were observed by fluorescent in situ hybridization (FISH), and a chromosome 22 abnormality was confirmed. These findings indicated that the disease was a neoplastic lesion.ConclusionExpression of the BCR-ABL fusion gene in INPN that develops in the oral cavity is thought to be very rare, and to the best of our knowledge, ours is the first case to be reported in the literature. About three postoperative years have passed, but findings suggestive of recurrence have not been observed.

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Epidemiology of Peripheral Nerve Sheath Tumors

Jack

Huie

Jacques

2021

Diagnostic Assessment and Treatment of Peripheral Nerve Tumors

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Oral perineurioma: clinicopathologic features from two cases and review of literature

Cited by 13 publications

References 51 publications

Oral peripheral nerve sheath tumors: A clinicopathological and immunohistochemical study of 32 cases in a Brazilian population

Oral peripheral nerve sheath tumors: A clinicopathological and immunohistochemical study of 32 cases in a Brazilian population

Intraosseous intraneural perineurioma derived from the inferior alveolar nerve with an abnormality of chromosome 22 and expression of the BCR-ABL fusion gene: report of a case and review of recent literature

Epidemiology of Peripheral Nerve Sheath Tumors

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