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口腔外神经软组织束膜瘤:1例具有法医学意义的罕见病例及文献综述

Extraneural Soft Tissue Perineurioma of the Oral Cavity: A Rare Case with Medico-Legal Implications and Literature Review.

作者信息

Pergolini Daniele, Mohsen Mohamed, Zaami Simona, De Paola Lina, Rocchetti Federica, Angileri Cinzia, Troiani Eduardo, Di Gioia Cira Rosaria Tiziana, Coppola Giulia, Palaia Gaspare

机构信息

Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, 00161 Rome, Italy.

Department of Anatomical, Histological, Forensic and Orthopedic Sciences, "Sapienza" University of Rome, 00161 Rome, Italy.

出版信息

Life (Basel). 2025 Aug 25;15(9):1343. doi: 10.3390/life15091343.

Abstract

Perineuriomas are a rare form of peripheral nerve sheath tumors, with occurrences in the oral cavity being exceptionally uncommon. This scarcity underscores the clinical significance of each documented case, as it facilitates enhanced diagnostic precision among oral health professionals. We hereby present a case involving a 68-year-old female patient with an extraneural perineurioma (EPN) located on the mandibular region. A laser-assisted excisional biopsy was performed, and the diagnosis of EPN was confirmed through histopathological examination complemented by immunohistochemical analysis. The lesion was surgically excised, and no recurrence was observed during a one-year follow-up period. Accurate recognition of EPNs in the oral cavity is crucial to prevent unnecessary aggressive surgical interventions. Misdiagnoses may occur in cases of fibromas, neurofibromas, schwannomas, ossifying fibromas, or low-grade malignancies, which can potentially result in overtreatment that may compromise both function and aesthetics. Given the rarity of oral EPN, precise diagnosis and appropriate management are essential to avoid unwarranted invasive procedures and to mitigate potential medico-legal implications originating from misdiagnosis or suboptimal treatment. Ensuring comprehensive informed consent and meticulous documentation is also vital in minimizing medico-legal risks.

摘要

神经束膜瘤是一种罕见的周围神经鞘瘤,在口腔中发生极为罕见。这种稀缺性凸显了每例已记录病例的临床意义,因为它有助于提高口腔健康专业人员的诊断准确性。我们在此报告一例涉及一名68岁女性患者的病例,其下颌区域存在神经外神经束膜瘤(EPN)。进行了激光辅助切除活检,并通过组织病理学检查及免疫组织化学分析确诊为EPN。病变经手术切除,在一年的随访期内未观察到复发。准确识别口腔中的EPN对于防止不必要的激进手术干预至关重要。在纤维瘤、神经纤维瘤、施万细胞瘤、骨化性纤维瘤或低度恶性肿瘤的病例中可能会发生误诊,这可能会导致过度治疗,进而可能影响功能和美观。鉴于口腔EPN的罕见性,精确诊断和适当管理对于避免不必要的侵入性手术以及减轻因误诊或治疗不当引发的潜在医疗法律问题至关重要。确保全面的知情同意和细致的记录对于将医疗法律风险降至最低也至关重要。

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