MRI features of peripheral traumatic neuromas

Ahlawat, Shivani; Belzberg, Allan J.; Montgomery, Elizabeth A.; Fayad, Laura M.

doi:10.1007/s00330-015-3907-9

Cited by 51 publications

(26 citation statements)

References 26 publications

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“…Treatment approaches for TBN include conservative management or surgery. The conservative approach, which has been reported to be successful in 50% of the cases, includes injection of a long-acting local anesthetic, corticosteroids, anti-inflammatory and antidepressant irritation to an injured but non severed nerve and terminal neuromas that have a bulbous-end morphology as a result of a partial disruption or total transection of the nerve as a result of surgery (5,7,10).…”

Section: Discussionmentioning

confidence: 99%

“…It is a disorganized tangled mass of axons, Schwann cells and perineural fibroblasts that is formed as a result of a failed attempt to reestablish axonal continuity following disruption of neuronal axons (3). Although TN is a well-established finding in patients who have undergone amputation (4), it, however, may occur in almost any anatomical site of the body and may resemble a peripheral nerve sheath tumor on imaging (5). Histologically, TN is characterized by a nonencapsulated, disordered proliferation of small nerve fascicles, composed of axons, Schwann cells, endoneurial and perineurial cells, embedded in dense fibrous stroma (6,7).…”

Section: Introductionmentioning

confidence: 99%

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Traumatic neuroma as a rare cause of intractable neuropathic breast pain following cancer surgery: Management and review of the literature

Salemis¹

2018

IRDR

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Traumatic neuroma of the breast after cancer surgery is a very rare clinical entity with only a few cases having been reported to date. We herein present a very rare case of traumatic breast neuroma in a postmenopausal patient with a history of breast-conserving surgery, who presented with a four-month history of intractable neuropathic breast pain. Diagnostic evaluation and management are discussed along with a review of the literature. Traumatic breast neuromas are very rare benign lesions that have been reported mainly after mastectomy. Our literature review yielded only 35 cases of traumatic breast neuromas in 28 patients, reported so far. Although imaging features may be indicative of a benign lesion, surgical excision is necessary to obtain a definitive diagnosis and to rule out a recurrent breast cancer. Conservative treatment is feasible in properly selected cases with asymptomatic neuromas after an accurate tissue sampling. The case presented herein underlines the necessity to consider traumatic neuroma in the differential diagnosis in patients with a history of breast surgery presenting with refractory neuropathic breast pain. A high index of suspicion is required because the lesion may be too small and can be missed on imaging investigations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Traumatic neuroma as a rare cause of intractable neuropathic breast pain following cancer surgery: Management and review of the literature

Salemis¹

2018

IRDR

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“…They can occur in any location, not only in the limbs, but also in the visceral and cranial nerves [4]. From a radiological point of view, the differential diagnosis of the lesion includes Morton neuroma (no history of prior trauma or surgery and the involved nerve stays intact), mucosal neuromatosis (but they a usually multiple), solitary circumscribed neuroma (mostly affect the face and are usually located in dermis and there is no history of prior trauma or surgery), as well as neurofibroma and schwannoma (neither trauma, nor surgery are present) [2,5]. The main limitation of the reported case is the lack of histological confirmation, since the patient was not re-operated.…”

Section: Current Issues In Pharmacy and Medical Sciencesmentioning

confidence: 99%

“…The available methods include conservative treatment (opioids and non-opioid analgesic, antidepressants, anticonvulsants), minimally invasive procedure (cryoablation or direct injection of corticosteroid, ethanol, phenol) as well as the total excision. Various alternative methods such as acupuncture, physical therapy, neuromodulation has also been suggested [1][2][3][4].…”

Section: Current Issues In Pharmacy and Medical Sciencesmentioning

confidence: 99%

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Asymptomatic traumatic neuroma

Wrona

Mocarska²,

Wrona

et al. 2019

Current Issues in Pharmacy and Medical Sciences

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A rare case of asymptomatic traumatic neuroma, triggered by the performed amputation within the right thigh due to the osteosarcoma is reported. The MRI examination has shown a focal lesion at the end of the sciatic nerve, with isointense signal and weak contrast enhancement on T1-, high signal on T2-weighted images, without restriction diffusion on DWI. The morphology did not significantly change after 12 months, which confirms the primary diagnosis. The main limitation of the case is the lack of histological confirmation, since the lesion was not removed.

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Primary Site Identification of Soft‐Tissue Mass: Things to Know in MRI Assessment

Aoki

Fujisaki

Terasawa

et al. 2020

Magnetic Resonance Imaging

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The spectrum of soft‐tissue mass is varied, including neoplastic and nonneoplastic/inflammatory lesions. However, soft‐tissue tumors have similar imaging findings and, therefore, the diagnosis of soft‐tissue mass is challenging. Although careful assessment of the internal characteristics on imaging can often narrow the differential diagnoses, the differential diagnosis may be out of the question if identification of the soft‐tissue mass origin is missed. The purpose of this article is to review the imaging findings and the essential anatomy to identify the primary site of the soft‐tissue mass, and discuss the associated potential pitfalls. In order not to fall into a pitfall, recognition of characteristic imaging findings indicating the origin of the soft‐tissue mass and anatomical knowledge of the normal tissue distribution are necessary. Level of Evidence 5 Technical Efficacy Stage 3

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MRI features of peripheral traumatic neuromas

Abstract: • MRI features of neuromas include enhancement and lack of a target sign. • Contrast material cannot be used to distinguish traumatic neuromas from PNSTs. • Traumatic neuromas can simulate peripheral nerve neoplasms on imaging.

Cited by 51 publications

References 26 publications

Traumatic neuroma as a rare cause of intractable neuropathic breast pain following cancer surgery: Management and review of the literature

Traumatic neuroma as a rare cause of intractable neuropathic breast pain following cancer surgery: Management and review of the literature

Asymptomatic traumatic neuroma

Primary Site Identification of Soft‐Tissue Mass: Things to Know in MRI Assessment

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