Can Intraneural Perineuriomas Occur Intradurally? An Anatomic Perspective

Nikhil K. Prasad, R. Shane Tubbs, Kimberly K. Amrami, Peter J Dyck, Michelle M Mauermann, Caterina Giannini, Oreste de Divitiis, Robert J. Spinner

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Background: Intraneural perineuriomas are rare, benign lesions produced by the neoplastic proliferation of perineurial cells. They typically present in adolescents and affect nerves of the limbs. In our experience, we have not encountered a single case of classic intraneural perineurioma at an intradural location.

Objective: To determine whether intraneural perineuriomas could occur intradurally, given the prevalence of intradural nerve sheath tumors, and explain our findings with an anatomic perspective.

Methods: We retrospectively reviewed the high-resolution magnetic resonance images of 56 patients from an institutional registry of patients with intraneural perineurioma. All cases were analyzed for signs of proximal extension toward spinal nerves, roots, and spinal cord. A literature review was performed. The clinical, radiological, and histopathological features of potential intradural lesions were critically appraised against strict criteria for a diagnosis of classic intraneural perineurioma.

Results: Fifteen of 56 (27%) patients with intraneural perineurioma had a proximal localization in the lumbosacral or brachial plexus. Not a single case occurred proximal to the dorsal root ganglia (DRG). One case of trigeminal intraneural perineurioma occurred distal to the gasserian ganglion. A literature review did not reveal any convincing cases of classic intraneural perineuriomas occurring in an intraspinal intradural location and revealed only 1 possible case in an intracranial intradural location.

Conclusion: Based on our study, the occurrence of classic intraneural perineuriomas intradurally is exceedingly rare, if at all present. This may be related to the paucity of perineurial cells at the nerve root level and reciprocal interactions between neuroglial cells at the central-to-peripheral transition zones.

Original languageEnglish (US)
Pages (from-to)226-234
Number of pages9
JournalNeurosurgery
Volume80
Issue number2
DOIs
StatePublished - Feb 1 2017

Fingerprint

Nerve Sheath Neoplasms
Lumbosacral Plexus
Trigeminal Ganglion
Brachial Plexus
Spinal Nerve Roots
Spinal Ganglia
Neuroglia
Registries
Spinal Cord
Magnetic Resonance Spectroscopy
Extremities
Cell Proliferation

Keywords

  • Adolescent
  • Brachial plexus
  • Nerve sheath neoplasms
  • Neuroglia
  • Spinal glia
  • Spinal nerves

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Can Intraneural Perineuriomas Occur Intradurally? An Anatomic Perspective. / Prasad, Nikhil K.; Tubbs, R. Shane; Amrami, Kimberly K.; Dyck, Peter J; Mauermann, Michelle M; Giannini, Caterina; de Divitiis, Oreste; Spinner, Robert J.

In: Neurosurgery, Vol. 80, No. 2, 01.02.2017, p. 226-234.

Research output: Contribution to journalReview article

Prasad, Nikhil K. ; Tubbs, R. Shane ; Amrami, Kimberly K. ; Dyck, Peter J ; Mauermann, Michelle M ; Giannini, Caterina ; de Divitiis, Oreste ; Spinner, Robert J. / Can Intraneural Perineuriomas Occur Intradurally? An Anatomic Perspective. In: Neurosurgery. 2017 ; Vol. 80, No. 2. pp. 226-234.
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T1 - Can Intraneural Perineuriomas Occur Intradurally? An Anatomic Perspective

AU - Prasad, Nikhil K.

AU - Tubbs, R. Shane

AU - Amrami, Kimberly K.

AU - Dyck, Peter J

AU - Mauermann, Michelle M

AU - Giannini, Caterina

AU - de Divitiis, Oreste

AU - Spinner, Robert J.

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N2 - Background: Intraneural perineuriomas are rare, benign lesions produced by the neoplastic proliferation of perineurial cells. They typically present in adolescents and affect nerves of the limbs. In our experience, we have not encountered a single case of classic intraneural perineurioma at an intradural location.Objective: To determine whether intraneural perineuriomas could occur intradurally, given the prevalence of intradural nerve sheath tumors, and explain our findings with an anatomic perspective.Methods: We retrospectively reviewed the high-resolution magnetic resonance images of 56 patients from an institutional registry of patients with intraneural perineurioma. All cases were analyzed for signs of proximal extension toward spinal nerves, roots, and spinal cord. A literature review was performed. The clinical, radiological, and histopathological features of potential intradural lesions were critically appraised against strict criteria for a diagnosis of classic intraneural perineurioma.Results: Fifteen of 56 (27%) patients with intraneural perineurioma had a proximal localization in the lumbosacral or brachial plexus. Not a single case occurred proximal to the dorsal root ganglia (DRG). One case of trigeminal intraneural perineurioma occurred distal to the gasserian ganglion. A literature review did not reveal any convincing cases of classic intraneural perineuriomas occurring in an intraspinal intradural location and revealed only 1 possible case in an intracranial intradural location.Conclusion: Based on our study, the occurrence of classic intraneural perineuriomas intradurally is exceedingly rare, if at all present. This may be related to the paucity of perineurial cells at the nerve root level and reciprocal interactions between neuroglial cells at the central-to-peripheral transition zones.

AB - Background: Intraneural perineuriomas are rare, benign lesions produced by the neoplastic proliferation of perineurial cells. They typically present in adolescents and affect nerves of the limbs. In our experience, we have not encountered a single case of classic intraneural perineurioma at an intradural location.Objective: To determine whether intraneural perineuriomas could occur intradurally, given the prevalence of intradural nerve sheath tumors, and explain our findings with an anatomic perspective.Methods: We retrospectively reviewed the high-resolution magnetic resonance images of 56 patients from an institutional registry of patients with intraneural perineurioma. All cases were analyzed for signs of proximal extension toward spinal nerves, roots, and spinal cord. A literature review was performed. The clinical, radiological, and histopathological features of potential intradural lesions were critically appraised against strict criteria for a diagnosis of classic intraneural perineurioma.Results: Fifteen of 56 (27%) patients with intraneural perineurioma had a proximal localization in the lumbosacral or brachial plexus. Not a single case occurred proximal to the dorsal root ganglia (DRG). One case of trigeminal intraneural perineurioma occurred distal to the gasserian ganglion. A literature review did not reveal any convincing cases of classic intraneural perineuriomas occurring in an intraspinal intradural location and revealed only 1 possible case in an intracranial intradural location.Conclusion: Based on our study, the occurrence of classic intraneural perineuriomas intradurally is exceedingly rare, if at all present. This may be related to the paucity of perineurial cells at the nerve root level and reciprocal interactions between neuroglial cells at the central-to-peripheral transition zones.

KW - Adolescent

KW - Brachial plexus

KW - Nerve sheath neoplasms

KW - Neuroglia

KW - Spinal glia

KW - Spinal nerves

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