Soft-Tissue Perineurioma of the Bulbar Conjunctiva

Perineurioma is a rare soft-tissue tumor with characteristic histologic and immunohistochemical features. The diagnosis; however, can be met with certain challenges. A 71-year-old woman presented with an enlarging painless mass in the right lower eyelid–cheek junction. The lesion presented as a raised overhanging trunk-shaped mass. An excisional biopsy and local reconstruction were performed. The overall morphology and immunohistochemical findings were most supportive of a cellular soft-tissue perineurioma, with differential diagnoses including dermatofibroma. To the authors’ knowledge, this is the first histopathologically reported case of a superficially occurring soft-tissue perineurioma in the eyelid–cheek junction. The authors discuss the presentation, relevant literature, and controversies associated with this diagnosis.

Section: Discussionmentioning

confidence: 99%

Eyelid–Cheek Junction Soft-Tissue Perineurioma: Case Report and Controversies

Zhao

Jarrar²,

Hussain

et al. 2021

Orbital Perineurioma in the Setting of Dacryocystitis

Chen

Zakka

Kazim

2012

A benign orbital perineurioma was discovered just posterior to the lacrimal sac during surgery for recurrent bacterial dacryocystitis in an 83-year-old woman. The tumor was circumscribed but nonencapsulated and located exterior to the lacrimal sac mucosa. It was composed of cytologically bland spindle cells organized in graceful, elongated, and twisted bundles reminiscent of a storiform pattern. Immunohistochemical staining displayed a diagnostic pattern of Claudin-1, GLUT-1, and epithelial membrane antigen positivity. Malignant transformation is virtually unknown, even with incomplete excision. The differential diagnosis includes neurofibroma, schwannoma, leiomyoma, solitary fibrous tumor (CD34 positive), and low-grade fibromyxoid sarcoma.

Soft Tissue Perineurioma of the Lacrimal Gland

Salter¹,

Chaump²,

Aswad³

et al. 2013

A 17-year-old Caucasian man presented with an enlarging, painless mass causing a bulge in the lateral aspect of the left upper eyelid. An MRI demonstrated a well-circumscribed lacrimal gland mass without bony erosion. A 1-cm lacrimal gland mass was excised. The morphology and immunohistochemical findings were supportive of a soft tissue perineurioma. To the authors' knowledge, they present the first case report of a soft tissue perineurioma involving the lacrimal gland.