Neurilemomas of the Lateral Region of the Neck

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NEURILEMOMAS of the lateral region of the neck are rare. Five were reported by Stout1 in 1935 in his series of 52 neurilemomas of peripheral nerves. Since that time only a small number of these tumors has been reported.2–7 By definition a neurilemoma is a benign neoplasm of the nerve sheath. There has been much controversy about the cellular origin of the tumor, largely because there are two distinct sheaths on peripheral nerves: the sheath of Schwann and the connective tissue sheath. Virchow,8 in 1863, considered the tumor to be a false neuroma. In 1910 Verocay9 demonstrated that its origin is in the sheath of Schwann, but applied the inadequate term of neurinoma. Mallory10 and Penfield11 believed the connective tissue sheath to be the site of origin. Masson12 supported Verocay’s theory, and was able to produce experimentally tumors of the nerve sheath, the origin of which could be traced to Schwann cells. These he therefore termed schwannomas. In 1935 Stout1 introduced the term neurilemoma, and in 1940, with Murray,13 confirmed by tissue culture the origin of these tumors from Schwann cells.

Neurilemomas of the lateral portion of the neck generally present themselves as solitary tumors lying either subcutaneously or deep within the neck. They grow slowly and usually are detected only when they become palpable. Only rarely is pain or tenderness a presenting symptom; such pain results from pressure on adjacent structures and does not originate in the nerve of origin of the tumor. The age and sex of. . .



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