Traumatic Neuroma
Definition
- Reactive proliferation of axons, Schwann cells and perineurial cells
Alternate/Historical Names
- Amputation neuroma
Diagnostic Criteria
- Usually occurs post-surgically, however can also follow minor trauma
- If injury occurs in a nerve plexus, multiple neuromas can arise
- Typically clinically a painful or tender nodule
- One of the five painful tumors of skin (see Lists at left)
- Nearly all < 5cm in greatest dimension
- Composed of haphazardly arranged tangles of variably sized regenerating nerve twigs
- Composed of axons ensheathed by Schwann cells surrounded by perineurium
- Unencapsulated
- Extension into adipose tissue or skeletal muscle is uncommon
- If present, usually limited
- Stroma usually fibrous
- May be myxoid
- Regenerating nerve twigs contain many neurofilament or Bielschowsky positive axons
- Surrounding Schwann cells are S100 positive
- Nerve twigs are surrounded by EMA and GLUT1 positive perineurium
- Excision is typically curative
Jason Karamchandani MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342
Original posting : 11/13/10
