Synonym: amputation neuroma
Clinical features:
(1) The patient has a history of trauma, usually involving transection of a nerve.
(2) The patient may experience pain or tenderness in the region of the transected nerve. This may be triggered by percussion or pressure on the nerve (Tinnel's sign).
(3) A palpable mass may develop.
(4) The patient may develop a paresthesia, dysesthesia or trigger point.
Situations where traumatic neuromas may be encountered include:
(1) amputations
(2) radical surgeries for cancer
(3) major trauma
Exploration at the site may show a small mass that consists of a disorganized tangle of neural elements with a collagen stroma. This is in continuity with the proximal end of the damaged nerve.
A traumatic neruoma is relatively stable and tends to grow very slowly if at all. On CT scan it shows a radiolucent center, dense peripheral rim and an intact layer of overlying fat.
Differential diagnosis:
(1) palisaded encapsulated neurofibroma
(2) neurofibroma
