Surgical Pathology Criteria–

Traumatic Neuroma

Differential Diagnosis

Traumatic Neuroma Localized Interdigial Neuritis (Morton Neuroma)
Can occur anywhwere Occurs in plantar and palmar digital nerves
History of trauma or surgery No history of prior trauma or surgery
Disorganized, microfascicular architecture Nerve is intact
Haphazardly arranged axons Axons decreased in number

Mucosal Neuromatosis Traumatic Neuroma
Typically multiple Generally isolated lesions
Solitary mucosal neuromas resemble traumatic neuromas, and the two lesions may be related

Traumatic Neuroma Solitary Circumscribed (Palisaded Encapsulated) Neuroma
Can occur anywhere 90% of lesions affect the face
Usually located in soft tissue Usually located in dermis
History of trauma or surgery No history of prior trauma or surgery
Can have irregular margin Generally circumscribed
Numerous well formed small nerve twigs Random proliferation of Schwann cells and axons
EMA+ perineurium surrounds individual nerve twigs EMA+ perineurium restricted to periphery of the entire neuroma

Neurofibroma Traumatic Neuroma
No history of prior trauma or surgery History of trauma or surgery
Random proliferation of Schwann cells and axons Numerous well formed small nerve twigs
Widespread soft tissue infiltration Limited soft tissue infiltration
Contain scarce admixed axons Contain abundant haphazardly arranged axons

Schwannoma Traumatic Neuroma
No history of prior trauma or surgery History of trauma or surgery
Random proliferation of Schwann cells and axons Numerous well formed small nerve twigs
Circumscribed/encapsulated Ill defined
Antoni A, Antoni B areas and Verocay bodies No such patterns in traumatic neuroma
Contain rare axons (predominantly subcapsular) Contain abundant haphazardly arranged axons

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