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Presented by Dr. Ashley Cimino-Mathews and prepared by Dr. Katherine Fomchenko
This case is an elderly female with a parotid mass. There is no known history of malignancy, and a previous biopsy was benign.
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1. Question
This case is an elderly female with a parotid mass. There is no known history of malignancy, and a previous biopsy was benign.
Correct
Answer: A. Traumatic Neuroma
Histology: The lesion consists of a disorganized proliferation of peripheral nerve bundles with intervening scar tissue. The nerve fibers form irregular clusters with intervening fibrous scar. The lesion is relatively well-circumscribed but not encapsulated, with surrounding skeletal muscle.
Discussion: Traumatic neuromas are non-neoplastic lesions that develop in the setting of previous trauma to an area, usually in the form of a prior biopsy or procedure at the site of the lesion. The lesion contains both axonal cells and Schwann cells. In contrast, a Schwannoma is a benign peripheral nerve sheath tumor composed entirely of Schwann cells, is encapsulated, has hyalinization of blood vessels, and has hypocellular (Antoni A) and hypercellular (Antoni B) areas. Neurofibromas are a benign peripheral nerve sheath tumor composed of all components of the nerve sheath, with spindled cells, hyalinized stroma, and mast cells.
Zabaglo M, Dreyer MA. Neuroma. 2022 Jan 9. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 31751028.
Alotaiby FM, Fitzpatrick S, Upadhyaya J, Islam MN, Cohen D, Bhattacharyya I. Demographic, Clinical and Histopathological Features of Oral Neural Neoplasms: A Retrospective Study. Head Neck Pathol. 2019 Jun;13(2):208-214. doi: 10.1007/s12105-018-0943-1. Epub 2018 Jun 21. PMID: 29931661; PMCID: PMC6513954.
Incorrect
Answer: A. Traumatic Neuroma
Histology: The lesion consists of a disorganized proliferation of peripheral nerve bundles with intervening scar tissue. The nerve fibers form irregular clusters with intervening fibrous scar. The lesion is relatively well-circumscribed but not encapsulated, with surrounding skeletal muscle.
Discussion: Traumatic neuromas are non-neoplastic lesions that develop in the setting of previous trauma to an area, usually in the form of a prior biopsy or procedure at the site of the lesion. The lesion contains both axonal cells and Schwann cells. In contrast, a Schwannoma is a benign peripheral nerve sheath tumor composed entirely of Schwann cells, is encapsulated, has hyalinization of blood vessels, and has hypocellular (Antoni A) and hypercellular (Antoni B) areas. Neurofibromas are a benign peripheral nerve sheath tumor composed of all components of the nerve sheath, with spindled cells, hyalinized stroma, and mast cells.
Zabaglo M, Dreyer MA. Neuroma. 2022 Jan 9. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 31751028.
Alotaiby FM, Fitzpatrick S, Upadhyaya J, Islam MN, Cohen D, Bhattacharyya I. Demographic, Clinical and Histopathological Features of Oral Neural Neoplasms: A Retrospective Study. Head Neck Pathol. 2019 Jun;13(2):208-214. doi: 10.1007/s12105-018-0943-1. Epub 2018 Jun 21. PMID: 29931661; PMCID: PMC6513954.
