Gomes da Silva Wagner, Martínez Marisol Martínez, Miranda Águida Maria Menezes Aguiar, Silva Roberto Bastos, da Silveira Henrique Martins, de Almeida Oslei Paes, Pires Fábio Ramôa
Oral Pathology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil.
Stomatology Service, Brazilian Dental Association, Rio de Janeiro, Rio de Janeiro, Brazil.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Mar;123(3):e91-e98. doi: 10.1016/j.oooo.2016.09.223. Epub 2016 Oct 12.
The present study reports two cases of oral perineuriomas, including a clinicopathologic review of the 39 published cases (17 intraneural and 22 extraneural perineuriomas) in the English language literature. In the first case, the tumor occurred in an 84-year-old male as a painless, asymptomatic, 20-mm submucosal nodule on the right lower mucobuccal fold near to the premolar area. In the second case, a 46-year-old female presented with a painless, 25-mm, slow-growing, fibrous, pedunculated nodule on the right buccal mucosa. In the first case, the tumor was composed of spindle cells arranged in a storiform pattern, classified as intraneural perineurioma; and in the second, it was an extraneural perineurioma, showing a whorled myxoid stroma. Immunohistochemical analysis confirmed the diagnosis by showing positivity for vimentin, EMA, and Glut-1 in case 1 and EMA, Glut-1, Claudin-1, and CD34 (focally) in case 2. Complete surgical removal was performed for both tumors, and there was no evidence of local recurrence after a long-term follow-up.
本研究报告了两例口腔神经束膜瘤病例，包括对英文文献中已发表的39例病例（17例神经内神经束膜瘤和22例神经外神经束膜瘤）的临床病理回顾。第一例中，肿瘤发生在一名84岁男性身上，为右下颌磨牙区附近颊黏膜皱襞处一个无痛、无症状的20毫米黏膜下结节。第二例中，一名46岁女性右侧颊黏膜出现一个无痛、25毫米、生长缓慢、纤维性、带蒂结节。第一例中，肿瘤由呈漩涡状排列的梭形细胞组成，分类为神经内神经束膜瘤；第二例为神经外神经束膜瘤，表现为漩涡状黏液样间质。免疫组织化学分析通过显示病例1中波形蛋白、上皮膜抗原（EMA）和葡萄糖转运蛋白1（Glut-1）阳性以及病例2中EMA、Glut-1、紧密连接蛋白1和CD34（局灶性）阳性来确诊。两例肿瘤均行完整手术切除，长期随访后无局部复发迹象。
