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The malignant neuroma is a sarcoma growing from the sheath of a nerve. It has the same characters and clinical features as the innocent variety, only it grows more rapidly, and by destroying the nerve fibres causes motor symptoms jerkings followed by paralysis.
Plexiform neuroma is always congenital, and is found most frequently in the temporal region, the neck, and the sides of the face, but almost any part of the body may be affected. Christot reports two cases in which the tumors were located upon the cheek and the neck. Czerny observed a case in which the tumor involved the lumbar plexus.
They are quite insensitive, and their removal is only called for if they cause pain or show signs of malignancy. A #false neuroma# is an overgrowth of the sheath of a nerve. This overgrowth may result in the formation of a circumscribed tumour, or may take the form of a diffuse fibromatosis.
A tumour composed of newly formed nerve tissue is spoken of as a #true neuroma#; when ganglionic cells are present in addition to nerve fibres, the name ganglionic neuroma is applied. These tumours are rare, and are chiefly met with in the main cords or abdominal plexuses of the sympathetic system of children or young adults.
For several days a great degree of insensibility of the skin of the whole body was observed without any implication of the power of voluntary motion. He was entirely cured in eighteen days. Duhring reports a very rare form of disease of the skin, which may be designated neuroma cutis dolorosum, or painful neuroma of the skin.
When the disease is subsiding, the nutrition of the damaged nerves and muscles should be maintained by massage, baths, passive movements, and the use of the galvanic current. When deformity has been allowed to take place, operative measures may be required for its correction. Neuroma is a clinical term applied to all tumours, irrespective of their structure, which have their seat in nerves.
Exsection of the brachial plexus was performed, but gave only temporary relief. The man died in his eighty-fourth year of senile debility. According to Osler the tubercula dolorosa or true fascicular neuroma is not always made up of nerve-fibers, but, as shown by Hoggan, may be an adenomatous growth of the sweat-glands.
They may be soft or hard, solid or cystic, diffuse or circumscribed; they grow very slowly, and are almost always innocent, although recurrence has been occasionally observed. Cases of multiple endotheliomata of the skin have recently been described by Wise. Angioma, lymphangioma, and neuroma are described with the disease of the individual tissues.
The sarcoma tends to spread along the lymph spaces in the long axis of the nerve, as well as to implicate the surrounding tissues, and it is liable to give rise to secondary growths. The malignant neuroma is met with chiefly in the sciatic and other large nerves of the limbs.
In addition to being unsightly, they bleed freely when abraded, are liable to ulcerate from friction and pressure, and occasionally become the starting-point of melanotic cancer. Rodent cancer sometimes originates in the slightly pigmented moles met with on the face. Overgrowths in relation to the cutaneous nerves, especially the plexiform neuroma, occasionally originate in pigmented moles.
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