Magnetic resonance imaging features of choledochal traumatic neuroma / 中华消化外科杂志

Objective To summarize magnetic the resonance imaging (MRI) features of choledochal traumatic neuroma,and investigate the key points of diagnosis and differentiation.Methods This was a retrospective descriptive study.The clinicopathological data of 1 patient with choledochal traumatic neuroma who was admitted to the Yantaishan Hospital on 18 August,2015 were collected.The patient received pre-contrast and dynamic-contrast-enhanced MRI and MR cholangiopancreatography (MRCP).Observational indexes included:(1) imaging features:location,size,signal intensity and enhancement characteristics of the lesion;(2) treatment and prognosis:surgical treatment,pathological findings,results of immunohistochemical staining and clinical follow-up.After preoperative related examinations,the patient and relatives were willing to receive surgical therapy,and postoperative pathological examinations and immunohistochemical staining were conducted.The follow-up using outpatient examination was performed to detect the patient's recovery and clinical symptoms up to January 2016.Ultrasound and laboratory examinations [alanine transaminase (ALT),aspartate transaminase (AST),γ-glutamyl transpeptidase (GGT) and total bilirubin (TBil)] were also recorded.Results (1) Imaging features:pre-contrast MRI revealed a stricture and intra-lumen nodular in the middle portion of common bile duct.The nodular was measured 1.2 cm × 0.9 cm at maximum cross-section.The nodular was well-demarcated and homogeneous of hypointensity on T1-weighted image comparing to hepatic parenchyma,slight hyperintensity on T2-weighted image and slight hypointensity on fat-suppressed T2-weighted image.MRCP could demonstrate the nodular more clearly and dilation of distal bile duct and intra-hepatic bile ducts.The width of common bile duct was 1.4 cm.After administration of contrast materials,the nodular showed avid enhancement and delay enhancement,which was mild enhancement at the artery phase,and gradual increase at the portal vein phase and the delay phase.The length of central stricture of the common bile duct was 1.3 cm.There was no abnormal enhancement in liver,spleen and pancreas.No retroperitoneal lymphadenopathy could be seen.The imaging diagnosis was cholangiocarcinoma with dilation of bile ducts.(2) Treatment and prognosis:the patient received surgery for tumor resection and Roux-en-Y reconstruction.The removed gross specimen was a grey-white nodular measured 2.0 cm × 1.0 cm.The cute surface was grey-white and stiff.The microscopic evaluation revealed haphazard arrangement of nerve bundles within the hyperplasia fibrotic stroma.Normal biliary epithelial cells can be seen beside the nerve bundles.Immunohistochemical staining showed S-100 and Vimentin were positive.The index of Ki-67 was 5％.The patient was discharged at 14 days postoperatively with the good recovery.During postoperative 5-month follow-up,the patient had good recovery and jaundice seleras were disappeared.Ultrasound showed the bile ducts were not dilated.The results of laboratory examinations were normal.Conclusion MRI features of choledochal traumatic neuroma include an intra-lumen nodular with biliary stricture and avid and delay enhancement after contrast materials administration.

Treatment of the Traumatic Neuroma

Formation of the traumatic neuroma results from abnormal nerve regeneration following a peripheral nerve injury. Numerous treatment options have been described. However, there is no one way that is completely effective in the management of these peripheral neuromas. Prevention is best. It is important to maximize nonsurgical management, including pain management and physiotherapy. At the time of surgery, definitive neuroma resection and tension-free repair or coverage will provide the least amount of subsequent nerve irritation.

A Case of Traumatic Neuroma Probably Originated from Dorsal Digital Nerve / 대한피부과학회지

Neuromas are hyperplasia of axons and associated nerve sheath cells. Cutaneous neuromas are rare. Neuromas can be classified into three types: traumatic neuromas, solitary palisaded encapsulated neuromas, and multiple mucosal neuromas. Traumatic neuromas are tangles of neural fibers and connective tissue that develop following nerve injury. These usually present as a solitary, skin colored or pinkish, slowly growing, palpable and painful firm papule or nodule. A 15-year-old female patient presented a solitary 1.0x0.5 cm sized, pinkish palpable well-demarcated firm subcutaneous nodule on the right third proximal interphalangeal joint. We herein report a case of traumatic neuroma which probably originated from the dorsal digital nerve.

Tumores de nervios periféricos de la cavidad bucal: esudio epidemiológico / peripheral nerve tumors of the oral cavity: epidemiological study

Los tumores neurales son lesiones oriundas de los nervios periféricos, siendo raros en la cavidad bucal. Estas lesiones incluyen el neurofibroma, neuroma traumático, schwanoma tumor de células granulares y el neuroma encapsulado. Objetivo: El presente trabajo se propuso a estudiar la prevalencia de estos tumores en dos servicios de diagnostico oral. Material y Método: fue realizado, a través de análisis de informes histopatológicos, un estudio retrospectivo de los casos de tumores neurales solitarios en la cavidad bucal diagnosticados en el laboratorio de Patología de la Universidad de Pernambuco, en el período de 1.992 a 2.007, y en el servicio de Patología de la Universidad Federal de Sergipe, en el periodo de 2.000 a 2.007. Resultados: Fueron encontrados 28 tumores neurales benignos, de un total de 4,485 informes analizados. De una manera general, el género femenino fue el más afectado y la lengua el sitio de mayor predilección. Hubo una discreta tendencia del surgimiento de las lesiones en la 1ª, 2ª e 3ª Décadas de vida. Conclusión: el conocimiento de estas lesiones, aunque raras en la cavidad bucal, se torna imprescindible para los profesionales del área odontológica, visto que las estrategias de diagnostico y tratamiento son dependientes de los datos epidemiológicos encontrados en la literatura especializada

Peripheral nerve sheath tumors rarely occur in the oral cavity and include neurofibroma, traumatic neuroma, schwannoma, granular cell tumor and palisaded encapsulated neuroma. Aim: The purpose of the present study was to determine the prevalence of these tumors in patients referred in two oral diagnostic services. Material and Method: Specimens diagnosed as oral peripheral nerve sheath tumors archived in the oral pathology services of Universidade de Pernambuco, from 1992 to 2007, and Universidade Federal de Sergipe, from 2000 to 2007, were evaluated. Results: Twentyeight peripheral nerve sheath tumors were diagnosed. Neurofibroma was the tumor more prevalent, including 40% of the cases. In general, females were more affected than males and the most frequent oral site was the tongue. Children and young people were more prevalent. Conclusion: The knowledge of these lesions, even though rare in oral cavity, it is essential for dentistry professionals, since that diagnosis and treatment strategies are dependents to epidemiological data founded in the literature

Traumatic Neuroma following Lateral Neck Lymph Node Dissection in Medullary Thyroid Cancer Patient / 대한내분비외과학회지

A 57-year-old male patient was admitted for evaluation of an enlarged neck lymph node. Previously, the patient had undergone three operations for recurrent medullary thyroid cancer. In preoperative neck ultrasonography, several nodules were identified in right level 3, level 5 and central neck area, which were suspicious for recurrence of thyroid cancer. Selective neck dissection for nodules was performed. Pathologic reports for nodules in right level 3 area were consistent with traumatic neuroma.

A Case of Traumatic Neuroma / 대한피부과학회지

Neuromas are hyperplasia of axons and associated nerve sheath cells. Cutaneous neuromas are uncommon. Three kinds of true neuromas exist in the skin and mucous membranes: traumatic neuromas, solitary palisaded encapsulated neuromas, and multiple mucosal neuromas. Traumatic neuromas are usually solitary, skin-colored or pink, firm papules or nodules at the sites of scars following local trauma. A 2-year-old male patient presented a solitary rice grain sized, skin-colored painful and tender polypoid papule on the left 2nd finger. The lesion was superimposed on a small linear scar. The patient had taken a trauma by a broken piece of glass about one month before the development of the neuroma. We report a case of traumatic neuroma with a review of the literature.

Traumatic Neuroma around the Celiac Trunk after Gastrectomy Mimicking a Nodal Metastasis: A Case Report

Traumatic neuroma is a well-known disorder that occurs after trauma or surgery involving the peripheral nerve and develops from a nonneoplastic proliferation of the proximal end of a severed, partially transected, or injured nerve. We present a case of traumatic neuroma around the celiac trunk after gastrectomy in a 56-year-old man, which was confirmed by pathology. CT demonstrated the presence of a lobulated, homogeneous, hypoattenuating mass around the celiac trunk, mimicking a nodal metastasis.

A Case of Traumatic Neuroma in Infraorbital Nerve / 대한이비인후과학회지

The term "traumatic neuroma" is used to describe the nodular mass of regenerating axons and Schwann cells that develop at the end of a proximal nerve stump following partial or complete transection of a nerve. Traumatic neuromas of the head and neck are relatively rare, and pain is the main symptom. Several cases of the traumatic neuromas of the head and neck have been reported in the literature at such sites as oral cavity, maxillary division of the trigeminal nerve, the inferior alveolar of the mandible, the auriculotemporal nerve, the glossopharyngeal nerve, and the facial nerve. We experienced a 60-year-old woman with a painful mass in her right cheek, appearing 10 years after she had pricked her right cheek with an umbrella. This mass was excised and the pathologic diagnosis was traumatic neuroma. We report this case here with a review of the literature.

A Case of Neuroma Cutis / 대한피부과학회지

Neuromas are a hyperplasia of axons and associated nerve sheeth cells. Cutaneous neuromas are uncommon and three kinds of true neuromas exist in the skin and mucous membranes: traumatic neuromas, multiple mucosal neuromas and solitary palisaded encapsulated neuromas. Traumatic neuromas result from the overgrowth of nerve fibers in the severed ends of peripheral nerves. These present as a solitary, skin-colored or pink firm papule or nodule at the site of a scar following local trauma. We report a case of neuroma cutis which occurred in a middle-aged woman without any history of trauma.

TRAUMATIC NEUROMA: FOUR CASES REPORT

A Case of Neuroma Cutis / 대한피부과학회지

Cutaneous neuromas are uncommon, and three true neuromas exist in the skin: palisaded encapsulated neuroma, multiple mucosal neuroma, and traumatic neuroma. Traumatic neuroma is usually a solitary, skin-colored or pink, firm papule or nodule at the site a of scar following local trauma. The patient was a 51-year-old female and presented with a solitary 1X2X1.5cm sized erythematous to brownish tender polypoid firm mass on the left shoulder for 24 years. Although she could not remember any history of trauma or surgery on the lesional area, this case could be considered as traumatic neuroma on the basis of both the clinical and characteristic histological features and by ruling out other types of neuroma.