Neuroma

WikiDoc Resources for Neuroma
Articles
Most recent articles on Neuroma Most cited articles on Neuroma Review articles on Neuroma Articles on Neuroma in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Neuroma Images of Neuroma Photos of Neuroma Podcasts & MP3s on Neuroma Videos on Neuroma
Evidence Based Medicine
Cochrane Collaboration on Neuroma Bandolier on Neuroma TRIP on Neuroma
Clinical Trials
Ongoing Trials on Neuroma at Clinical Trials.gov Trial results on Neuroma Clinical Trials on Neuroma at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Neuroma NICE Guidance on Neuroma NHS PRODIGY Guidance FDA on Neuroma CDC on Neuroma
Books
Books on Neuroma
News
Neuroma in the news Be alerted to news on Neuroma News trends on Neuroma
Commentary
Blogs on Neuroma
Definitions
Definitions of Neuroma
Patient Resources / Community
Patient resources on Neuroma Discussion groups on Neuroma Patient Handouts on Neuroma Directions to Hospitals Treating Neuroma Risk calculators and risk factors for Neuroma
Healthcare Provider Resources
Symptoms of Neuroma Causes & Risk Factors for Neuroma Diagnostic studies for Neuroma Treatment of Neuroma
Continuing Medical Education (CME)
CME Programs on Neuroma
International
Neuroma en Espanol Neuroma en Francais
Business
Neuroma in the Marketplace Patents on Neuroma
Experimental / Informatics
List of terms related to Neuroma

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Synonyms and keywords: Traumatic neuroma; Morton neuroma; Joplin neuroma

Overview

Neuroma (Neuro- is from the Greek for nerve) is defined as a tumor of a nerve. However, neuroma commonly refers to any tumor of cells of the nervous system.

Historical Perspective

• Neuroma was first described by Thomas Morton in 1876

Classification

• Neuroma may be classified according to histopathological features into 3 groups:

• Morton neuroma

• Symptomatic perineural fibrosis around a plantar digital nerve of the foot
• Also known as Morton’s metatarsalgia.

• Traumatic neuroma

• Arises from nerve injury (often as a result of surgery).
• They occur at the end of injured nerve fibres as a form of uneffective, unregulated nerve regeneration
• Subtype of traumatic neuroma, called "Joplin neuroma" (a compression traumatic neuroma)
• Occurs most commonly near a scar
• Often very painful

• Neoplasic neuroma

• Solid nodular mass
• Are separate from nerve fibers

Pathophysiology

• The pathogenesis of neuroma is characterized by [feature1], [feature2], and [feature3].
• The [gene name] gene/Mutation in [gene name] has been associated with the development of neuroma , involving the [molecular pathway] pathway.
• On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of neuroma .
• On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of neuroma .

Causes

• Common causes of neuroma, include:

Differentiating Neuroma from other Diseases

• Neuroma must be differentiated from other diseases that cause forefoot pain, and numbness, such as:

• [Differential dx1]
• [Differential dx2]
• [Differential dx3]

Epidemiology and Demographics

• The prevalence of neuroma is approximately [number or range] per 100,000 individuals worldwide.
• In [year], the incidence of neuroma was estimated to be [number or range] cases per 100,000 individuals in [location].

Age

• Patients of all age groups may develop neuroma .

• Neuroma is more commonly observed among patients aged [age range] years old.
• Neuroma is more commonly observed among [elderly patients/young patients/children].

Gender

• Neuroma affects men and women equally.

• [Gender 1] are more commonly affected with neuroma than [gender 2].
• The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.

Race

• There is no racial predilection for neuroma .

• Neuroma usually affects individuals of the [race 1] race.
• [Race 2] individuals are less likely to develop neuroma .

Risk Factors

• Common risk factors in the development of neuroma are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

Natural History, Complications and Prognosis

• The majority of patients with neuroma remain asymptomatic for [duration/years].
• Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
• If left untreated, [#%] of patients with neuroma may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
• Common complications of neuroma include [complication 1], [complication 2], and [complication 3].
• Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with neuroma is approximately [#%].

Diagnosis

Diagnostic Criteria

• The diagnosis of neuroma is made when at least [number] of the following [number] diagnostic criteria are met:

• [criterion 1]
• [criterion 2]
• [criterion 3]
• [criterion 4]

Symptoms

• Neuroma is usually asymptomatic.
• Symptoms of neuroma may include the following:

• [symptom 1]
• [symptom 2]
• [symptom 3]
• [symptom 4]
• [symptom 5]
• [symptom 6]

Physical Examination

• Patients with neuroma usually appear [general appearance].
• Physical examination may be remarkable for:

• [finding 1]
• [finding 2]
• [finding 3]
• [finding 4]
• [finding 5]
• [finding 6]

Laboratory Findings

• There are no specific laboratory findings associated with neuroma .

• A [positive/negative] [test name] is diagnostic of neuroma .
• An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of neuroma .
• Other laboratory findings consistent with the diagnosis of neuroma include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Imaging Findings

• There are no [imaging study] findings associated with neuroma .

• [Imaging study 1] is the imaging modality of choice for neuroma .
• On [imaging study 1], neuroma is characterized by [finding 1], [finding 2], and [finding 3].
• [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

• Neuroma may also be diagnosed using [diagnostic study name].
• Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

• There is no treatment for neuroma ; the mainstay of therapy is supportive care.

• The mainstay of therapy for neuroma is [medical therapy 1] and [medical therapy 2].
• [Medical therapy 1] acts by [mechanism of action1].
• Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].

Surgery

• Surgery is the mainstay of therapy for neuroma .
• [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of neuroma .
• [Surgical procedure] can only be performed for patients with [disease stage] neuroma .

Prevention

• There are no primary preventive measures available for neuroma .

• Effective measures for the primary prevention of neuroma include [measure1], [measure2], and [measure3].

• Once diagnosed and successfully treated, patients with neuroma are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].