Schadel Caleb M, Anderson Craig W, Chi Angela C, Steed Martin B
Chief Resident, Department of Oral and Maxillofacial Surgery, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, SC.
Dental Student, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, SC.
J Oral Maxillofac Surg. 2019 Feb;77(2):329.e1-329.e7. doi: 10.1016/j.joms.2018.09.032. Epub 2018 Oct 4.
A perineurioma (PN) is a rare benign peripheral nerve sheath tumor derived from perineurial cells. Based on clinical and pathologic features, PNs can be classified into 2 major subtypes: intraneural PN (IPN) and the more common extraneural PN (EPN). EPNs and IPNs are extremely rare in the oral cavity, and there have been only 38 reported cases (21 EPNs, 17 IPNs). In the present case, a 20-year-old man presented with a painless left dorsal tongue mass. Excisional biopsy examination indicated a diagnosis of EPN based on microscopic examination with immunohistochemical analysis. Twenty-eight months later the patient presented again with concern for a recurrent lesion. Intraoral examination showed a firm nonulcerated left dorsal tongue mass. Re-excision and microscopic examination with immunohistochemical analysis confirmed the diagnosis of an EPN. This report presents an unusual case of EPN that arose in the tongue and potentially recurred, although the possibility of persistence versus true recurrence exists. In addition, the clinicopathologic characteristics of previously reported cases of oral PN are reviewed.
神经束膜瘤（PN）是一种罕见的良性周围神经鞘瘤，起源于神经束膜细胞。根据临床和病理特征，神经束膜瘤可分为2种主要亚型：神经内神经束膜瘤（IPN）和较常见的神经外神经束膜瘤（EPN）。神经外神经束膜瘤和神经内神经束膜瘤在口腔中极为罕见，仅有38例报道（21例神经外神经束膜瘤，17例神经内神经束膜瘤）。在本病例中，一名20岁男性患者出现左侧舌背无痛性肿块。切除活检检查通过显微镜检查及免疫组化分析确诊为神经外神经束膜瘤。28个月后，患者再次就诊，担心出现复发病变。口腔检查发现左侧舌背有一个质地硬、无溃疡的肿块。再次切除并进行显微镜检查及免疫组化分析，确诊为神经外神经束膜瘤。本报告介绍了一例罕见的发生于舌部且可能复发的神经外神经束膜瘤病例，不过存在持续存在与真正复发的可能性。此外，还对先前报道的口腔神经束膜瘤病例的临床病理特征进行了回顾。
