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At least 19 recordsLinked to original sources
PubMedDate not supplied

Cerebellopontine angle tumours, other than acoustic neuromas. A report on 34 cases. A presentation of 7 bilateral acoustic neuromas.

The symptoms, preoperative diagnostic results and histological findings in 34 cerebellopontine angle tumour cases, other than acoustic neuromas, are presented. The meningeomas dominate by far this group of tumours. The symptomatology is much less uniform than that of the acoustic neuromas, where the VIII nerve is dominant. The facial nerve is less involved, whereas the other cranial nerves give symptoms more frequently. One remarkable sign is the presence of severe trigeminal neuralgia, which we have not encountered in acoustic neuromas. Only 35% of the 'non-neuroma' patients had elevated spinal fluid protein, compared with 100% in our acoustic neuroma cases. Furthermore, 7 patients with bilateral acoustic neuromas are presented. The connection with von Recklinghausens disease and multiple meningeomas is discussed.

Adult↗
PubMed1986

Treatment of the painful neuroma by neuroma resection and muscle implantation.

The successful treatment of the painful neuroma remains an elusive surgical goal. This report evaluates one approach to the management of this problem which entails neuroma excision and placement of the proximal end of the nerve away from denervated skin, away from tension, and into a well-vascularized environment: muscle. Seventy-eight neuromas in 60 patients with a mean follow-up of 31 months (range 18 to 43 months) were evaluated. Sixty-seven percent of these patients involved Workmen's Compensation and 57 percent had had at least one previous operation to treat their pain. The results demonstrated good to excellent results in 82 percent of the treated nerves in the entire group. Factors that were predictive of a poorer outcome were (1) digital neuroma (p less than 0.0005), (2) Workmen's Compensation (p less than 0.01), and (3) three or more previous operations for pain (p less than 0.01). Transposition of nerves into small superficial muscles or muscles with significant excursion resulted in treatment failures. The etiology and histopathology of treatment failures are reviewed. Treatment of radial sensory neuromas by transposition of the radial sensory nerve into the brachioradialis muscle when any associated injury to the lateral antebrachial cutaneous nerve was also treated, gave good to excellent relief of pain, and improved hand function in 88 percent of the patients.

Adult↗
PubMed1989

Treatment of recurrent metatarsalgia by neuroma resection and muscle implantation: case report and proposed algorithm of management for Morton's "neuroma".

This report describes the theoretical basis for an approach to treating a recurrent Morton's "neuroma." The recurrence, being a true, classic neuroma, is treated by a technique validated in the treatment of the upper extremity painful neuroma: neuroma resection and muscle implantation. A plantar approach, implanting into the deep layer of intrinsics, was used. The three year success of this technique in a long-distance runner is reported.

Adolescent↗
PubMed1976

Comparative ultrastructure of thyroid, tongue and eyelid lesions in the neuroma phenotype of medullary carcinoma of the thyroid: association of amyloid with fibroblasts in thyroid tumor and in mucosal neuromas.

Electron-microscopic and histochemical studies of thyroid tumor, tongue neuromas and eyelid neuromas from the lesions of a patient with medullary thyroid carcinoma were compared. In the thyroid tumor, a significant number of the C cells showed heterogeneity of granule types; no C cells, however, were identified in the tongue and eyelid neuromas. Amyloid was clearly shown by Congo red staining in the thyroid neoplasm and in the tongue neuromas. In all tissues, amyloid fibrils were found to be ultrastructurally closely associated with fibroblasts. These fingings suggest that the fibroblast rather than the C cell may have played the important role in the deposition of amyloid in this patient's thyroid carcinoma.

Amyloid↗
PubMed1992

The palisaded, encapsulated neuroma (solitary circumscribed neuroma).

We describe the clinical and pathological features of 41 palisaded encapsulated neuromas. They present as small, solitary, asymptomatic papules, predominantly on the face in middle age. No case had co-existent neurofibromatosis or multiple mucosal neuromas. Histologically, they have distinctive features, consisting of a proliferation of Schwann cells and large numbers of axons within a perineurial derived capsule, permitting simple and reliable distinction from schwannomas and neurofibromas. Overall, the palisaded encapsulated neuroma accounts for approximately 25% of all nerve sheath tumours of the dermis. True schwannomas rarely occur in the dermis. Despite their original name, many cases are incompletely encapsulated and we support the recent proposal to rename these lesions solitary circumscribed neuroma.

Adolescent↗
PubMed1989

Solitary circumscribed neuroma of the skin (so-called palisaded, encapsulated neuroma). A clinicopathologic and immunohistochemical study.

Solitary, circumscribed neuroma is a distinctive benign cutaneous tumor that was first described under the name "palisaded, encapsulated neuroma" over 15 years ago. Despite the fact that it is not uncommon, it has received minimal attention and is very poorly known among pathologists. We have studied the clinicopathologic and immunohistochemical features of 39 cases. These lesions almost always present on the face or close to a mucocutaneous junction in middle-aged adults. Most examples measure less than or equal to 0.5 cm and are composed of a partially encapsulated mass of bland Schwann cells and innumerable tiny axons arranged in interlacing fascicles. The capsule is composed of perineural cells that show epithelial membrane antigen positivity. Solitary, circumscribed neuroma is not associated with von Recklinghausen's neurofibromatosis, nor is there evidence to support its possible relationship to the type IIb multiple endocrine neoplasia syndrome. This entity warrants wider recognition.

Adolescent↗
PubMed1977

The ultrastructure of oral neuromas in multiple mucosal neuromas, pheochromocytoma, medullary thyroid carcinoma syndrome.

The ultrastructure of oral neuromas from 2 patients with multiple mucosal neuromas, pheochromocytoma, medullary thyroid carcinoma syndrome reveals numerous hypertrophic unmyelinated and myelinated axons, hyperplastic neurilemmal cells and associated collagen fiber formation. These tumors are described and compared ultrastructurally with neurilemmomas and neurofibromas as described by other authors. On the basis of this comparison, these tumors are not considered to be of neurilemmal origin. On the basis of light and electron microscopic histology it is postulated that these tumors represent hypertrophy of axons similar to that noted in amputation neuromas.

Adolescent↗
PubMed1991

[Diagnostic strategy of acoustic neuroma. Evaluation of efficacy of auditory evoked potentials. Apropos of a series of 50 neuroma cases].

The authors carry out a retrospective study of the diagnostic procedures used in a series of 50 acoustic neuromas. AEP were performed for thirty-four neuromas at some stage of their history. The findings were perfectly normal for eight of them, which represents a sensitivity level of 76%. Various elements likely to account for this are put forward, then the role of AEP and MRI in the diagnostic strategy for neuroma is discussed in the light of this study. Finally, the authors emphasize the necessity to regularly evaluate the diagnostic methods in order to guarantee their quality and reliability.

Evoked Potentials, Auditory↗
PubMed1990

Hypoglossal neuroma following excision of a huge recurrent acoustic neuroma and facio-hypoglossal anastomosis. A complex management problem.

A case of neuroma of the intracranial part of the hypoglossal nerve, not associated with neurofibromatosis, is presented. The patient had previously undergone surgery for the removal of a contralateral acoustic neuroma, and subsequent facio-hypoglossal anastomosis. The importance of early diagnosis, pre-operative clinical assessment and post-operative care is stressed.

Adult↗
PubMed1988

Diagnostic strategies in search for acoustic neuromas. Findings in 300 acoustic neuroma patients.

The diagnostic findings in 300 patients with acoustic neuromas are reported. Because of a centralized treatment of acoustic neuromas, we have a uniform work-up of all the patients, which enables us to make a non-selected comparison of the diagnostic efficiency of the various tests. Diagnostic dilemmas in patients with normal hearing, anakusis, normal auditory brainstem recordings, normal vestibular function and normal tomography of the internal acoustic meatus are discussed. In patients with hearing better than 80 dB, a normal ABR, the presence of recruitment and a normal caloric reaction can exclude the presence of a tumour, making tomography superfluous. In patients with poor hearing, the need for tomography is imperative. We perform CT if two procedures among the following produce tumour-positive results: ABR, recruitment tests, caloric test, and tomography. Those who have only one tumour-positive finding at the screening are re-examined after one year. If, even with contrast enhancement, CT proves negative, we continue to perform air CT. Only then do we know for sure whether the patient has a tumour or not. An advantage with using many tests for the same physiological function is that they complement each other, though, on the other hand this often adds to the confusion. With fewer tests, the confusion is reduced, but the requirements regarding technical quality must be very stringent. ABR, the Metz recruitment test and tomography are purely objective, while the caloric test is subjective on the part of the investigator. The Hallpike procedure, however, has stood the test of time in separating pathologic from normal.

Adolescent↗
PubMed1988

[Pre- and postoperative hearing thresholds and brain stem potential in acoustic neuroma. Is neuroma-induced hearing loss reversible?].

Following acoustic neuroma excision through the middle fossa route hearing was maintained in 30% (8.8% of all patients with acoustic neuroma) within 20 dB compared with preoperative thresholds. Acoustic evoked brain stem responses had the tendency to normalise within 2 to 6 months following surgery. In individual cases hearing function was improved.

Auditory Threshold↗
PubMed1990

Pharyngeal traumatic neuromas and traumatic neuromas with mature ganglion cells (pseudoganglioneuromas).

Over a period of 4 years, 14 cases of traumatic neuroma were detected in laryngoscopic biopsy specimens. The approximate incidence was 10% of biopsy specimens from this area. The most frequent symptoms in descending order of frequency, were hoarseness, dysphagia, choking spells, intermittent aphonia, and cough. Six (43%) of the 14 lesions contained mature ganglion cells. These lesions have not been reported in the pharyngeal region, and I suspect that in the past a few similar conditions have been diagnosed as ganglioneuromas. Because the lesion appears to be the cause of the symptoms and is a reactive, nonneoplastic process, accurate diagnosis and commensurate management are important.

Adult↗