Introduction: Palisaded encapsulated Neuroma (PEN) is a rare benign neural tumor, often localized on faces and sometimes observed in a striking predilection on the skin of the face. This tumor might also occur in oral cavity, especially on the tongue. Some researchers have speculated that PEN is hamartomatosis, and there is a possible role of frequent trauma in its etiology.Case Report: Our case was a 27-year-old female with a painless flat swell in the right lingual mandibular gingiva. This lesion was formed about a year ago without any radiographic appearance. Fibroma and lipoma were included in the differential diagnosis of the lesion. Benign spindle cell tumor was reported in this reported according to histopathological examination results. Afterwards, immunohistochemical and silver stains were performed on desmin, S100, alpha-smooth muscle actin (a-SMA) and neuron-specific enolase markers for definitive diagnosis. The final diagnosis was PEN due to positive staining for S100 and NSE, as well as positive silver staining.Conclusion: According to the results, accurate diagnosis of PEN and differentiating it from other spindle cell tumors could help in the selection of the best treatment and prevention of unnecessary procedures.

Background: Acoustic Neuroma (AN), also known as vestibular schwannoma, is a benign, generally slow-growing tumor which might result in hearing loss, tinnitus, and disequilibrium. There are currently studies showing that the mean duration from the original operation and the diagnosis of recurrence was 4. 2 years and the main recurrent symptoms were intracranial hypertension and walking disorder. Objectives: This study aimed to investigate the risk factors of postoperative recurrence of acoustic Neuroma (AN) and provide a reference for its clinical prevention and treatment. Methods: This retrospective study included a total of 30 patients with recurrent AN and 23 patients with non-recurrent AN who were admitted to the Department of Neurosurgery of the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China from January 2013 to December 2018. The recurrence rate during the same periods was calculated and surgical treatment was decided according to the tumor size. The surgical effects of the recurrent patients further compared and investigated the way different treatments affected the preservation of the auditory nerve, facial nerve, and posterior group nerve and increased facial paralysis in AN patients. Results: Univariate analysis of 30 recurrent AN cases showed that tumor size, internal auditory canal invasion, and tumor blood supply are linked to the recurrence of AN (P<0. 05). In addition, the multi-factor analysis demonstrated that rich blood supply, medium texture, intratumoral canal invasion, incomplete resection, and large-diameter tumor were independent risk factors for recurrent AN. We observed a significant difference in the preservation of the auditory nerve, but not in the preservation of the facial nerve and posterior nerve, and between the recurrent and non-recurrent AN patients. Conclusion: This study analyzed the risk factors of postoperative recurrence in patients with acoustic Neuroma. The results showed that small size of tumor, tumor blood supply, tumor texture, tumor vascular invasion, and incomplete tumor resection were independent risk factors for recurrent AN patients. Therefore, these factors can be included in the reference indexes, and relevant prevention and treatment measures can also be taken during the operation to reduce the risk of postoperative recurrence.

Mucocele and traumatic Neuroma are two lesions related to the traumatic events; however there is only one reported case in which these two entities were perceived simultaneously.The current study reported a 21-year-old man who complained of painless recurrent swelling, accompanied by paresthesia on his left lower labial mucosa. He had a previous history of similar lesion and had been treated with surgery and cauterization last year. The primary clinical impression was a recurrent mucocele. Microscopic surveys displayed a traumatic Neuroma in the vicinity of a mucocele which seems to be arising from the previous surgical treatment.

Background: Fibrous obliteration or appendiceal Neuroma is a rare type of appendiceal tumor that causes appendiceal obstruction and then presents as appendicitis. This neural tumor has no specific presentation and, after appendectomy, is diagnosed by the pathologist accidentally. Fibrous obliteration is described as a proliferative lesion. The pathogenesis of this lesion is unknown, but it is mentioned that the etiology of this problem is secondary to recurrent inflammation processes. These processes cause neuroendocrine cell hyperplasia in the submucosa and lamina propria of the wall of the appendix. The repetitive occurrence of these sub-clinical inflammatory processes causes fibrosis. Cases Report: We presented a 55-year-old woman who was referred to our clinic with persistent pain in the right lower quadrant for five days in this report. The pain mimicked appendicitis presentation, and it suddenly started from the periumbilical area and then shifted to the right lower quadrant of the abdomen. Her laboratory study showed a 9600/microliter white blood cell count with 70% neutrophils. An increase in the appendix loop with 9 millimeters diameter was reported in the ultrasound. There was also severe fat haziness around the tissues and visceral inflammation of the terminal ileum in the sonogram. She underwent an appendectomy after the diagnosis of appendicitis, and the pathologist diagnosed fibrous obliteration or appendiceal Neuroma. Conclusion: It is concluded that fibrous obliteration or appendiceal Neuroma mimics acute appendicitis, and in patients with this presentation, appendectomy is the best choice for treatment. The main diagnostic method is pathologic assessment, and it is important for the differentiation of this tumor from other malignant tumors of the appendix because fibrous obliteration is a benign tumor.

Introduction: Morton's Neuroma is a painful, degenerative neuropathy that is initially managed with conservative treatments. In refractory cases, surgical excision is typically indicated. Minimally invasive percutaneous procedures provide a viable alternative to surgery. Objective: While both pulsed radiofrequency (PRF) and conventional radiofrequency (CRF) have been individually reported as effective treatments for Morton’s Neuroma, we aim to utilize a combination of PRF and CRF for pain management. Case Presentation: We report the case of a 61-year-old male with a five-year history of right foot Morton’s Neuroma, presenting with severe pain that was refractory to conservative management, including multiple corticosteroid injections. Radiofrequency was performed as follows: 5 minutes at 42°C, 1 minute at 60°C, and 1 minute at 70°C. Result: The patient experienced significant pain relief, with follow-up Numerical Rating Scale (NRS) of 1 at two weeks, 1 at one month, and 2 at seven months post-treatment. Conclusions: This case suggests that the combined application of PRF and CRF may serve as a promising alternative for managing refractory Morton’s Neuroma.

Background: Traumatic peripheral nerve injuries (PNIs) caused by penetrating and lacerated trauma are among the most prevalent microsurgical injuries. Post-treatment follow-up and prognosis of patients undergoing repair are often based on clinical examinations and electrodiagnostic findings. Therefore, a reliable, inexpensive, useful, and rapidly accessible diagnostic method is necessary during the patient's follow-up. Objectives: This study aimed to assess the relationship between ultrasound imaging and treatment outcomes in patients with median peripheral nerve injury. Methods: In this cohort study, 21 eligible patients with symptoms of acute median nerve injury (MNI) caused by penetrating trauma in microsurgery were studied from June 2018 to June 2019. The patients underwent ultrasonography three months after repair and were followed up for at least nine months. The outcomes of the treatment were compared with those obtained six months after ultrasonography. Results: In all studied patients, mean thicknesses of the repaired nerve on the distal and the proximal sides were 2. 58± 0. 51 and 2. 51± 0. 61 mm2, respectively; 12 cases (57. 1%) recovered very well nine months after surgery and in nine cases (42. 9%) no nerve recovery was observed based on clinical electromyography (EMG) examinations and nerve conduction velocity (NCV). The amount of Neuroma formed at the repair site was lower in well-recovered patients (1. 5± 0. 4 mm3) than those with no recovery (4. 9± 1. 5 mm3). No re-rupture was observed at the repair site. Each group underwent two-four repairs of flexor tendons. Conclusion: Ultrasound can be used as an effective and non-invasive method for assessment of PNI and follow-up of reconstructive surgery.

Palisaded encapsulated (solitary circumscribed) Neuromas (PENs) are relatively common intraoral neurogenic tumors, which occur most frequently on the hard palate. Herein, we describe the clinicopathological characteristics of a palisaded encapsulated Neuroma of the tongue. This tumor was an exophytic sessile mass measuring 0.3× 0.4 cm with rubbery consistency on the anterior one-third of the dorsum of the tongue. The tumor was excised under the impression of a pyogenic granuloma (PG). No recurrence was reported at 12 months postoperatively. Histopathological examination showed a well-circumscribed mass that composed of interlacing fascicles of spindle cells. The cells were S-100 positive. The nuclei, showing parallel orientation within the fascicles, were wavy and pointed and showed no sign of mitotic activity. Giemsa staining revealed no mast cells within the stroma.