Abstract
Perineuriomas are benign neoplasms arising from perineural cells. They are mainly divided into two categories as intraneural and extraneural, and frequently seen in soft tissues. Cutaneous perineuriomas are extremely rare tumors, there are only four reported in the literature. Here we describe a patient with intraneural perineurioma of the left index finger. The patient is a forty-eight year old African American female who presented with a bump on her left index finger for the last 3 years. Firm but non- tender mass was palpated on the pulp of the finger with a measurement of 1.5 x 1 cm. An excisional biopsy was performed to reveal a plexiform neoplasm expanding the dermis with multiple variable sized, circumscribed nodules subtended by a collagenous stroma. Each nodule was composed of cells that vary from spindled to epithelioid features with bland nuclei and relatively abundant, eosinophilic cytoplasm. Pseudo-onion blub architectural arrangement was appreciated. Overlying epidermis and the surgical margins were not involved. Tumor cells showed positive staining with EMA and Glut-1 where S100 was positive only in scattered residual Schwann cells. Taken together with the immunochemical profile, this morphology was consistent with diagnosis of intraneural perineurioma. Although rare, intraneural perineuriomas of the skin exist. It is the dermatopathologists role to recognize these benign but unusual neoplasms to guide therapy. According to our search, this case is the 5th reported in the literature.
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