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Case Reports
. 2018 Aug;7(3):185-190.
doi: 10.5582/irdr.2018.01041.

Traumatic neuroma as a rare cause of intractable neuropathic breast pain following cancer surgery: Management and review of the literature

Nikolaos S Salemis  1
Affiliations
Case Reports

Traumatic neuroma as a rare cause of intractable neuropathic breast pain following cancer surgery: Management and review of the literature

Nikolaos S Salemis. Intractable Rare Dis Res. 2018 Aug.

Abstract

Traumatic neuroma of the breast after cancer surgery is a very rare clinical entity with only a few cases having been reported to date. We herein present a very rare case of traumatic breast neuroma in a postmenopausal patient with a history of breast-conserving surgery, who presented with a four-month history of intractable neuropathic breast pain. Diagnostic evaluation and management are discussed along with a review of the literature. Traumatic breast neuromas are very rare benign lesions that have been reported mainly after mastectomy. Our literature review yielded only 35 cases of traumatic breast neuromas in 28 patients, reported so far. Although imaging features may be indicative of a benign lesion, surgical excision is necessary to obtain a definitive diagnosis and to rule out a recurrent breast cancer. Conservative treatment is feasible in properly selected cases with asymptomatic neuromas after an accurate tissue sampling. The case presented herein underlines the necessity to consider traumatic neuroma in the differential diagnosis in patients with a history of breast surgery presenting with refractory neuropathic breast pain. A high index of suspicion is required because the lesion may be too small and can be missed on imaging investigations.

Keywords: Neuroma; breast; neuropathic; pain; traumatic.

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Figures

Figure 1.
Figure 1.
Specimen radiography showing clustered microcalcifications (arrow), along with a small area of architectural distortion (star).
Figure 2.
Figure 2.
Histopathological findings of traumatic breast neuroma. (A) The tumor consists of haphazardly arranged, eosinophilic cells with oval to spindle nuclei, without atypia, necrosis or mitosis. (Hematoxylin and Eosin ×400); (B) Tangles of small and medium, well circumscribed nerve fiber bundles, that do not invade the surrounding fibroadiposal tissue.(Hematoxylin and Eosin ×100); (C) High power photomicrograph, of eosinophilic cells, with bubbly cytoplasm, bland, oval to spindle nuclei, without significant atypia. The periphery of the nodule is composed of perineural cells, while the inside consists of proliferated Swann cells. (Hematoxylin and Eosin ×400).
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