Neuroma morphology: A macroscopic classification system.

Area of Science:

• Surgical Pathology
• Pain Medicine
• Clinical Anatomy

Background:

• Neuromas, nerve tumors, vary in size and shape.
• The relationship between neuroma morphology and patient symptoms is not well understood.

Purpose of the Study:

• To investigate macroscopic traits of excised human neuromas.
• To assess a novel morphological classification system for neuromas.
• To explore potential clinical implications of neuroma morphology.

Main Methods:

• Collected 45 terminal neuroma specimens from 27 patients undergoing surgery.
• Obtained intraoperative images and prospectively collected pain data.
• Developed and assessed inter-rater reliability (IRR) of a three-group morphological classification (bulbous, fusiform, atypical).

Main Results:

• The classification system demonstrated strong IRR (Cohen's kappa = 0.8).
• Atypical neuromas were associated with higher preoperative pain scores compared to bulbous and fusiform types.
• Atypical morphology was more frequent in patients with diabetes and peripheral vascular disease.

Conclusions:

• A validated morphological classification for neuromas has been established.
• This classification may aid in understanding symptomatic neuroma development and clinical outcomes.
• Further research is needed to explore the link between neuroma morphology and the vascular/metabolic environment.