September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Palisaded encapsulated neuroma of the eyelid: Clinicopathological correlation
Author Affiliations & Notes
  • Shaza N Al-Holou
    Henry Ford Hospital, Detroit, Michigan, United States
  • Eric D Hansen
    Bascom Palmer Eye Institute, Miami, Florida, United States
  • Antonio Bermudez
    Bascom Palmer Eye Institute, Miami, Florida, United States
  • Maria Paula Fernandez
    Bascom Palmer Eye Institute, Miami, Florida, United States
  • Sander R Dubovy
    Bascom Palmer Eye Institute, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Shaza Al-Holou, None; Eric Hansen, None; Antonio Bermudez, None; Maria Paula Fernandez, None; Sander Dubovy, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2414. doi:
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      Shaza N Al-Holou, Eric D Hansen, Antonio Bermudez, Maria Paula Fernandez, Sander R Dubovy; Palisaded encapsulated neuroma of the eyelid: Clinicopathological correlation. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2414.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : To describe and characterize the clinical and histopathological characteristics of palisaded encapsulated neuromas (PEN) of the eyelid and ocular adnexa.

Methods : A retrospective review of the Florida Lions Ocular Pathology Laboratory archives at the Bascom Palmer Eye Institute was performed under approval of the institutional review board. Cases of PEN were identified by accessing medical records from January 1, 1998 to May 1, 2015. Histopathological features were identified using hematoxylin and eosin, S-100, epithelial membrane antigen (EMA), and anti-neurofilament staining.

Results : Fourteen cases were identified through a review of medical records. Lesions ranged from in size from 1.0 mm to 14.0 mm in diameter and were light tan to brown in color. The mean age at time of diagnosis was 56.9 years (range of 36 to 86). Seven patients (50.0%) were male. Of the eleven cases located in the upper or lower eyelid, 63.6% of cases were present in the upper eyelid (N = 7). Two cases were located at the medial or lateral canthus, and one case was conjunctival. Thirteen cases were located on the right lid (92.9%). Microscopic examination revealed a well-defined solitary encapsulated tumor located in the dermis composed of fascicles of spindle-shaped cells with relatively abundant eosinophilic cytoplasm and indistinct borders. Spindle-shaped cells and axons in the tumor were highlighted by S-100 and anti-neurofilament stains respectively, and the tumor capsule was highlighted by EMA.

Conclusions : Palisaded encapsulated neuroma (PEN) is a benign cutaneous tumor commonly located in the head and neck. Few reports are present in the literature on the clinical characteristics of PENs of the eyelid. This is also the first report describing PEN in the conjunctiva. PEN is likely underrecognized by ophthalmologists due to lack of recognition of the entity. As PEN is often a benign, solitary lesion that is not associated with systemic syndromes and rarely recurs, it is important to distinguish this entity from tumors such as basal cell carcinoma or other neural tumors which require further systemic workup.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.


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