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Nelke K, Janeczek M, Pasicka E, Żak K, Łukaszewski M, Nienartowicz J, Gogolewski G, Maag I, Kuropka P, Dobrzyński M. Traumatic Neuroma of the Hard Palate Mimicking a Small Salivary Gland Tumor-A Case Report. Biomedicines 2024; 12:1688. [PMID: 39200153 PMCID: PMC11351310 DOI: 10.3390/biomedicines12081688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 07/24/2024] [Accepted: 07/26/2024] [Indexed: 09/01/2024] Open
Abstract
In the case of any pathologies arising in the hard palate, it is always important to exclude their possible odontogenic origins. Cone-beam computed tomography is mandatory. In cases where a possible non-teeth-related pathology is confirmed, each clinician should remember possible differential diagnostics. Many small salivary glands between the mucosa and bone are present in this palatal area. Both benign and malignant tumors arising from the small glands, and mucosa of the hard palate, might occur. The case presented here mimics a solid tumor because of the nodule consistency. Because of a healthy palatal mucosa without any erosions or irritations with firm attachment to the submucosal nodule, a possible malignant tumor of small salivary gland origins was suspected in this case. When the tumor diameter is small, an excisional biopsy is required to collect good and representative material for further histopathological evaluation. In most cases, bulky nodules present on the palate are hard on palpation, non-movable, and covered with healthy mucosa. Possible bone infiltrations with mucous membrane ulcerations could manifest a more expansive character of the lesion. In the presented case, an unusual occurrence of a traumatic neuroma without any past traumatic etiology of the palate was first differentiated from the occurrence of adenoid-cystic carcinoma (ACC), pleomorphic adenoma, other benign/malignant small gland tumors, or atypical, fibroma/schwannoma of the palate. This paper presents treatment options for this rare oral neural tumor occurrence in the palate and differential diagnosis between hard palate tumors in a 42-year-old male patient, furthermore highlighting the role of an excisional biopsy as a good source for a tissue sample.
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Affiliation(s)
- Kamil Nelke
- Maxillo-Facial Surgery Ward, EMC Hospital, Pilczycka 144, 54-144 Wrocław, Poland;
- Academy of Applied Sciences, Health Department, Academy of Silesius in Wałbrzych, Zamkowa 4, 58-300 Wałbrzych, Poland;
| | - Maciej Janeczek
- Division of Animal Anatomy, Department of Biostructure and Animal Physiology, Wrocław University of Environmental and Life Sciences, Kożuchowska 1, 51-631 Wrocław, Poland;
| | - Edyta Pasicka
- Division of Animal Anatomy, Department of Biostructure and Animal Physiology, Wrocław University of Environmental and Life Sciences, Kożuchowska 1, 51-631 Wrocław, Poland;
| | - Krzysztof Żak
- Academy of Applied Sciences, Health Department, Academy of Silesius in Wałbrzych, Zamkowa 4, 58-300 Wałbrzych, Poland;
| | - Marceli Łukaszewski
- Department of Anaesthesiology and Intensive Care, Sokołowski Hospital, Alfreda Sokołowskiego 4, 58-309 Wałbrzych, Poland;
| | - Jan Nienartowicz
- Private Practise of Maxillo-Facial Surgery, Romualda Mielczarskiego 1, 51-663 Wrocław, Poland;
| | - Grzegorz Gogolewski
- Department of Emergency Medicine, Wrocław Medical University, Borowska 213, 50-556 Wrocław, Poland;
| | - Irma Maag
- Maxillo-Facial Surgery Ward, EMC Hospital, Pilczycka 144, 54-144 Wrocław, Poland;
| | - Piotr Kuropka
- Division of Histology and Embryology, Department of Biostructure and Animal Physiology, Wrocław University of Environmental and Life Sciences, Cypriana K. Norwida 25, 50-375 Wrocław, Poland;
| | - Maciej Dobrzyński
- Department of Pediatric Dentistry and Preclinical Dentistry, Wrocław Medical University, Krakowska 26, 50-425 Wrocław, Poland;
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Shin SH, Kim HM, Son EJ. Traumatic Neuroma in the External Auditory Canal. J Craniofac Surg 2024; 35:00001665-990000000-01300. [PMID: 38270440 PMCID: PMC11045544 DOI: 10.1097/scs.0000000000009969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/26/2023] [Indexed: 01/26/2024] Open
Abstract
Traumatic neuroma is the reparative proliferation of axons and Schwann cells at the proximal end of a severed nerve following injury or surgery. Traumatic neuromas with or without clinical symptoms have rarely been reported in the external auditory canal. A 50-year-old woman with a history of trauma visited our otorhinolaryngology clinic with a 7 × 5-mm mass localized on the anterior wall of the external auditory canal. The mass was easily removed via surgical excision and was histopathologically diagnosed as a neuroma. No signs of recurrence were observed after excision. Herein, the authors present this case, along with a review of the literature.
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Affiliation(s)
- Seung Ho Shin
- Department of Otorhinolaryngology, Yongin Severance Hospital, Yonsei University College of Medicine
| | - Hye Min Kim
- Department of Pathology, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Jin Son
- Department of Otorhinolaryngology, Yongin Severance Hospital, Yonsei University College of Medicine
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Trigeminal Traumatic Neuroma: a Comprehensive Review of the Literature Based On a Rare Case. Curr Pain Headache Rep 2022; 26:219-233. [PMID: 35119601 DOI: 10.1007/s11916-022-01018-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Traumatic neuromas in general, and trigeminal traumatic neuromas in particular, are relatively rare entities originating from a damage to a corresponding nerve or its branches. This manuscript is a comprehensive review of the literature on trigeminal traumatic neuromas based on an interesting and challenging case of bilateral intraoral lesions. RECENT FINDINGS The diagnosis for this patient was bilateral trigeminal traumatic neuromas. It is possible that these patients have a genetic predisposition to the development of these lesions. It is a neuropathic pain condition and may mimic dental and other trigeminal pain entities. Topical treatment with lidocaine gel, utilizing a custom-made neurosensory stent, rendered the patient significant and sustained pain relief. Trigeminal traumatic neuromas present a diagnostic challenge even to a seasoned clinician, due to the complex clinical features that may mimic other entities. Topical medications such as local anesthetics may be a good viable alternative to systemic medications to manage the pain associated with the condition. Early identification of the lesion and the associated pain helps in the succinct management of symptomatic trigeminal traumatic neuromas.
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