Intra-osseous soft tissue perineurioma of the inferior alveolar nerve

This report describes an intra-osseous perineurioma affecting the inferior alveolar nerve, the second at this site, of a 53-year-old man. It produced a well defined, partially corticated, round radiolucency associated with resorption of the root apices of 36 and 37. Histology showed a circumscribed, partially encapsulated cellular tumour composed of bland spindle cells with undulating nuclei and indistinct cell membranes arranged in interlacing fascicles. The tumour was strongly positive for epithelial membrane antigen, collagen IV and laminin, with only scattered S100-positive cells and lack of CD34 expression. Electron microscopy showed elongated cells with continuous external laminae of basement membrane-like material, subplasmalemmal densities, desmosome-like junctions, and variable numbers of micropinocytotic vesicles. The lesion was surgically excised and in 9 months there has been no recurrence.