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Clinical Problem Solving: Pathology
Jan 2012

Pathology Quiz Case 1: Diagnosis

Arch Otolaryngol Head Neck Surg. 2012;138(1):96. doi:10.1001/archoto.2011.163-b

Diagnosis: Soft-tissue perineurioma

Perineuriomas are uncommon, solid, well-circumscribed, slowly growing benign peripheral nerve sheath tumors that are composed of well-differentiated perineural cells. Four variants of perineuriomas are recognized: intraneural, soft-tissue, sclerosing, and reticular.1 In 1978, Lazarus and Trombetta2originally described soft-tissue perineuriomas as benign peripheral nerve sheath tumors that are distinct from schwannomas and neurofibromas. Soft-tissue perineuriomas occur most commonly in the subcutis of the extremities and trunk of young to middle-aged adults with approximately equal sex distribution.1 They are rare in children, and their location in the pediatric age group have included the hands, face, retroperitoneum, and scrotum.3 To our knowledge, there have been no previous reports of soft-tissue perineurioma in the neck of a child.