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Skeletal Radiology

, Volume 49, Issue 1, pp 109–114 | Cite as

Extraneural perineurioma: CT and MRI imaging characteristics

  • Stephen M. BroskiEmail author
  • Laurel A. Littrell
  • Benjamin M. Howe
  • Andrew L. Folpe
  • Doris E. Wenger
Scientific Article
  • 142 Downloads

Abstract

Objective

To examine the CT and MRI characteristics of extraneural perineuriomas.

Materials and methods

With IRB approval, our institutional imaging database was retrospectively reviewed for cases of pathologically proven extraneural perineuriomas. CT and MRI features were recorded, correlative imaging analyzed, and the electronic medical record cross-referenced.

Results

We identified ten patients [(seven males, three females, mean age 49.4 ± 18.3 years (range, 16–70 years)]. All cases were pathologically confirmed. Nine cases were conventional soft tissue extraneural perineuriomas, including one with “reticular” features and one with histologic features of malignancy; the tenth case contained admixed Schwann cells (hybrid perineurioma/schwannoma). Six out of ten patients underwent CT and ten of ten MRI evaluation. Nine out of ten MRIs were performed with IV contrast. Five lesions were subcutaneous, four intermuscular, and one intramuscular. Mean lesion diameter was 4.3 ± 2.7 cm (range, 0.9–10.2 cm). Nine out of ten lesions were well circumscribed; one had irregular margins. On CT, five of six were hypodense and one isodense compared to skeletal muscle. Most lesions were T1 isointense (5/10) or hypointense (4/10) and T2 hyperintense (7/10) relative to skeletal muscle, and demonstrated solid enhancement (6/9). There was no evidence of muscular denervation on any MRI exam, and a nerve of origin was identified in two out of ten cases.

Conclusions

Extraneural perineuriomas have a distinctly different imaging appearance from intraneural perineuriomas, manifesting as rounded or ovoid soft tissue masses, without evidence of muscular denervation, and usually without an apparent nerve of origin. Because these features mimic other benign and malignant soft tissue lesions, including sarcomas, biopsy or excision is needed for definitive diagnosis.

Keywords

Extraneural perineurioma CT MRI Peripheral nerve Tumor 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

The need for informed consent was waived by the Institutional Review Board.

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Copyright information

© ISS 2019

Authors and Affiliations

  1. 1.Department of RadiologyMayo ClinicRochesterUSA
  2. 2.Department of Laboratory Medicine and PathologyMayo ClinicRochesterUSA

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