J Yeungnam Med Sci.  2022 Apr;39(2):168-171. 10.12701/yujm.2021.01088.

Palisaded encapsulated neuroma on the lower lip: a case report

• Seol JE
• Hong SM
• Ahn SW
• Kim JU
• Jin WJ
• Park SH
• Kim H

• KMID: 2529276
• DOI: http://doi.org/10.12701/yujm.2021.01088

Abstract

Palisading encapsulated neuroma is a rare, benign, cutaneous nerve sheath tumor. It usually occurs as an asymptomatic solitary skin-colored papule and commonly affects the nose and cheeks. Sometimes, it involves other sites, including the shoulder, upper arm, and trunk, but rarely involves the oral mucosa, including that of the lip. In our case, a 63-year-old female patient complained of a pinkish rubbery nodule on her lower lip. Histopathologic examination demonstrated a well-circumscribed nodule encapsulated by connective tissue stroma in the dermis. The nodule consisted of palisading spindle-shaped tumor cells with wavy and basophilic nuclei. The cells were arranged in streaming fascicles with multiple clefts and were strongly positive for S-100 proteins. To our knowledge, only three cases of palisading encapsulated neuroma on the lower lip have been reported in the Korean literature. Herein, we report a rare case of an oral palisaded encapsulated neuroma.

Keyword

Benign neoplasm; Lip; Nerve sheath tumor; Neuroma

Figure

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  Fig. 1. Clinical photograph revealing a 0.4×0.4 cm solitary pinkish nodule on the lower lip.

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  Fig. 2. (A) Histopathologic examination of the lower lip tissue shows a well-circumscribed nodule encapsulated by connective tissue stroma in the dermis (hematoxylin and eosin [H&E] stain, ×12.5). (B) The nodule consists of palisading spindle-shaped tumor cells with wavy, basophilic nuclei arranged as streaming fascicles and separated by clefts (H&E stain, ×100). (C, D) The tumor cells are strongly positive for S-100 proteins (immunohistochemical stain, [C] ×12.5, [D] ×100). (E) Neurofilament protein staining is focally positive within spindle cell fascicles, indicating the presence of axons (immunohistochemical stain, ×100).

Reference

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