Abstract
AbstractPerineurioma is an uncommon benign tumour of the nerve sheath composed exclusively of well‐differentiated perineurial cells. It usually affects the limbs or trunk; intraoral lesions are uncommon. A rare case of perineurioma is described involving the mandibular dental nerve in a 59‐year‐old female, microscopically characterised by a combined pattern of intraneural and soft tissue perineurioma. The patient was referred for treatment of a lesion in the mandible. Panoramic radiography revealed a well‐delimited osteolytic lesion with radiopaque halo in an edentulous region of the left mandible. Occlusal view showed no expansion of cortical bone. A surgical procedure for incisional biopsy disclosed a connection between the tumour and the alveolar inferior nerve. Grossly, an enlargement of the affected nerve was described. Microscopic examination showed tumour cells arranged in pseudo‐onion bulb structures, with scattered collagen bundles, and areas with a whorled (storiform) arrangement. Many concentric whorls of spindle cells exhibiting thin, elongated eosinophic processes were seen. Immunohistochemical study exhibited strong positivity for epithelial membrane antigen. We report a rare case of perineurioma affecting the mandibular dental nerve showing both intraneural and soft tissue microscopic patterns and discuss morphological aspects for differential diagnosis.
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