Traumatic neuroma after neck dissection: CT characteristics in four cases

BACKGROUND AND PURPOSE: Traumatic neuroma, an attempt by an injured nerve t o regenerate, mag present as a palpable nodule or an area sensitive to touc h (trigger point) after neck dissection. The purpose of this study was to i dentify CT characteristics of traumatic neuroma in four patients after neck dissection. METHODS: Between April 1995 and November 1998, the CT studies in three men and one woman (ages, 45-64 years) who had had a radical neck dissection and a nodule posterior to the carotid artery were reviewed retrospectively, CT was performed 1.5 to 6 years after neck dissection with clinical correlati on and/or pathologic examination. Three patients had squamous cell carcinom a of the upper aerodigestive tract and one had a primary parotid adenocarci noma, RESULTS: Three patients with a traumatic neuroma had a centrally radiolucen t nodule with peripherally dense rim and intact layer of overlying fat, whi ch was stable on CT studies for 1 to 2 years, One of these had a clinical t rigger point. The fourth patient with a pathologically proved traumatic neu roma mixed with tumor had intact overlying fat, but the nodule lacked a rad iolucent center and was not close to the carotid artery, CONCLUSION: The CT findings of a stable nodule that is posterior but close to the carotid artery with central radiolucency, a dense rim, and intact ov erlying fat, combined with the clinical features of a trigger point and a l ack of interval growth, strongly suggest the diagnosis of traumatic neuroma .