Fact-sheet: Traumatic neuroma
Updated on 04/18/2018 at 3:46 PM
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Definition
Non-neoplastic proliferation corresponding to a disorganized attempt at nerve repair.
2 types:
- Spindle neuromas: secondary to chronic microtrauma of an intact nerve
- Terminal (end-bulb) neuromas: severe trauma/partial or complete nerve transection
Onset 1 to 12 months after trauma
Histology: disorganized, non-encapsulated cluster of axons, Schwann cells, endoneurial and perineurial cells, within a dense collagen matrix, surrounded by fibroblasts
Clinical features
Pain ± palpable swelling
Most frequent locations: lower limbs post-amputation +++, head and neck (particularly the oral cavity post dental extraction in 50%)
Ultrasound
Fusiform neuroma: fusiform mass or focal enlargement, with afferent and efferent nerve
Terminal neuroma: afferent nerve ending in a "bulb"
CT
Early enhancement of nerve endings
MRI
Mass hypointense on T1, hyperintense on T2, enhancing after gadolinium injection