Thomas Mentzel, MD

Solitary circumscribed neuroma (“palisaded encapsulated neuroma”) represents a well-circumscribed, partly encapsulated, dermal, neural neoplasm.

Solitary circumscribed neuroma is composed of S100 positive Schwann cells. Often preexisting peripheral nerves image are seen on the base of these lesions.



  • Represents proliferation of peripheral nerve fibers in which ratio of axons to Schwann cell fascicles approaches 1:1

    • Solitary circumscribed neuroma (“palisaded encapsulated neuroma”) represents spontaneous proliferation of peripheral nerve fibers

    • Multiple mucosal neuromas associated with multiple endocrine neoplasia syndrome (type 2B) represent rare autosomal dominant condition

    • Traumatic neuroma represents post-traumatic proliferation of peripheral nerve fibers

    • Morton neuroma represents degenerative neural change with reactive fibrosis on the foot

    • Pacinian neuroma represents painful hyperplasia of pacinian bodies on finger

    • Epithelial sheath neuroma represents proliferation of enlarged dermal nerves ensheathed by squamous epithelium


Developmental Anomaly

  • Multiple mucosal neuromas in multiple endocrine neoplasia syndrome

    • Represents rare autosomal dominant condition

    • Also includes medullary carcinoma of thyroid, pheochromocytoma, and somatic abnormalities

    • Mucosal neuromas have been rarely reported without any other systemic features of the syndrome

Environmental Exposure

  • Traumatic neuroma

    • Amputation neuroma represents painful, reactive proliferation of nerve fibers after amputation

    • Supernumerary digit represents proliferation of nonencapsulated nerve fibers after intrauterine or perinatal amputation of supernumerary digits

    • Lesion on penis may occur after circumcision

  • Morton neuroma

    • Degenerative damage of peripheral nerves



  • Age

    • Solitary circumscribed neuroma is most common in 5th and 7th decades

  • Gender

    • Solitary circumscribed neuroma occurs in equal ratio in both genders


  • Solitary circumscribed neuroma

    • Majority (90%) located on face

    • Rare in other anatomic locations

    • Mucosal involvement has been reported rarely

  • Morton neuroma

    • Usually in distal parts of peripheral nerves of 3rd and 4th os metatarsale

  • Pacinian neuroma

    • Usually on fingers


  • Painful or painless mass

  • Slow growing


  • Surgical approaches

    • Simple excision is curative


  • Biologically benign lesions


General Features

  • Raised dermal lesions

Jul 9, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Neuroma

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