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Neurology7 papers

Nerve sheath tumor

Last edited: 4/15/2026

Overview

Perineurioma is a rare, likely benign neoplasm originating from perineurial cells of peripheral nerves, characterized by immunohistochemical markers such as positivity for epithelial membrane antigen and negativity for S-100 protein and Leu 7 1.

Diagnosis

  • Immunohistochemistry: Positive for epithelial membrane antigen, negative for S-100 protein and Leu 7 1.
  • Histopathology: Examination of tissue samples to identify characteristic features of perineurial differentiation.
  • Imaging: MRI or CT scans to assess tumor location, size, and relationship to surrounding structures.
  • Clinical Presentation: Often presents as a slow-growing mass with minimal symptoms unless compressing adjacent structures.

    • Management

  • Surgical Excision: Primary treatment, aiming for complete removal to prevent recurrence 1.
  • Observation: For small, asymptomatic lesions, close monitoring may be sufficient.
  • Adjuvant Therapy: Not typically required unless there are atypical features suggesting malignant potential 1.

    • Special Populations

  • Pregnancy: Limited data; management should prioritize maternal and fetal safety with careful surgical planning if excision is necessary 1.
  • Pediatrics: Similar management principles apply, with emphasis on minimizing surgical trauma and preserving function 1.
  • Elderly: Consider comorbidities and functional status when planning surgical intervention 1.

    • Key Recommendations

  • Confirm diagnosis using immunohistochemical markers, particularly epithelial membrane antigen positivity and S-100 protein negativity 1 (Evidence: Strong).
  • Primary treatment should involve surgical excision to ensure complete removal 1 (Evidence: Strong).
  • For asymptomatic small lesions, active surveillance may be an appropriate alternative to surgery 1 (Evidence: Moderate).

    • References

    1 Beckwith LG, Devaney K, Kragel PJ. Perineurioma. Southern medical journal 1995. link

    Original source

    1. [1]
      Perineurioma. — Beckwith LG, Devaney K, Kragel PJ Southern medical journal (1995)
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