Intraosseous intraneural perineurioma derived from the inferior alveolar nerve with an abnormality of chromosome 22 and expression of the BCR-ABL fusion gene: report of a case and review of recent literature

• Published in: World journal of surgical oncology Vol. 16; no. 1; p. 189
• Main Authors: Kurihara, Jun, Yokoo, Satoshi, Ichikawa, Miku, Shimizu, Takahiro, Ogawa, Masaru, Seki, Mai
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 13.09.2018; BioMed Central; BMC
• Subjects: Abl protein; Adult; Alveoli; Anesthesia; BCR protein; BCR-ABL fusion gene; Biopsy; Care and treatment; Case Report; Case reports; Chromosome 22; Chromosome 22 abnormality; Chromosomes; Chromosomes, Human, Pair 22 - genetics; Computed tomography; Diagnosis; Enlargement; ENPN; Fluorescence; Fluorescence in situ hybridization; Fusion protein; Fusion Proteins, bcr-abl - genetics; Gene expression; Genes, abl - genetics; Genetic aspects; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; INPN; Kinases; Literature reviews; Magnetic resonance imaging; Male; Mandibular canal; Mandibular Neoplasms - diagnosis; Mandibular Neoplasms - diagnostic imaging; Mandibular Neoplasms - genetics; Mandibular Neoplasms - surgery; Mandibular Nerve - pathology; Mandibular Nerve - surgery; Medical imaging; Neoplasm Recurrence, Local; Nerve Sheath Neoplasms - diagnosis; Nerve Sheath Neoplasms - diagnostic imaging; Nerve Sheath Neoplasms - genetics; Nerve Sheath Neoplasms - surgery; NMR; Nuclear magnetic resonance; Oral cavity; Perineurioma; Perineurium; Peripheral nervous system diseases; Prognosis; Schwann cells; Tumor cells; Tumors; INPN; Perineurioma; BCR-ABL fusion gene; Chromosome 22 abnormality; ENPN
• ISSN: 1477-7819; 1477-7819
• DOI: 10.1186/s12957-018-1481-8

Perineurioma (PN) is a peripheral nerve disease that primarily develops in the limbs and trunk and very rarely occurs in the oral cavity. PN is classified into two types: intraneural perineurioma (INPN) and soft tissue perineurioma (extraneural perineurioma, ENPN). In this article, we report a patient with mandibular body INPN derived from the perineurium of the inferior alveolar nerve. The patient was a 43-year-old male. He consulted our department for a detailed examination of the right mandibular body. A biopsy was performed at another hospital and he was diagnosed with a schwannoma. At his first visit, hypesthesia extending from the right lower lip to the mental region was recognized and enlargement of the right mandibular canal was confirmed with X-ray CT and MRI. Considering the possibility of future tumor growth, we extirpated the tumor under general anesthesia. Cystic tumor was seen continuously in the inferior alveolar nerve. Immunohistologically, the tumor cells were positive for Glut-1, weakly positive for EMA, and weakly positive for Claudin-1, and the histopathological diagnosis was INPN. In addition, absence of the BCR region of chromosome 22 and expression of the BCR-ABL fusion gene were observed by fluorescent in situ hybridization (FISH), and a chromosome 22 abnormality was confirmed. These findings indicated that the disease was a neoplastic lesion. Expression of the BCR-ABL fusion gene in INPN that develops in the oral cavity is thought to be very rare, and to the best of our knowledge, ours is the first case to be reported in the literature. About three postoperative years have passed, but findings suggestive of recurrence have not been observed.