A Pacinian hyperplasia of the foot

Bilateral symptomatic Pacinian corpuscle hyperplasia of the adult foot

Pacinian hyperplasia in the human body has been rarely described in the literature with most cases reported involving the hand (Fassola et al., 2019). This hyperplasia is considered a reactive lesion as opposed to a neoplasm (Satge et al., 2001), with the most common presenting complaint being pain and swelling (Fassola et al., 2019). In this study, a case of bilateral Pacinian corpuscle hyperplasia in the adult foot not previously described in the literature is presented.

Pacinian corpuscle hyperplasia: A review of the literature

OBJECTIVE

Pacinian corpuscle hyperplasia typically presents as a tender nodule on the volar aspect of the palm or digit, often after trauma. Histologically, it presents as one to multiple normal-sized to enlarged Pacinian corpuscles in the deep dermis or subcutaneous adipose tissue. Given its rarity, its pathogenesis is debated and nomenclature is poorly defined. Herein, we present a case of Pacinian corpuscle hyperplasia and review the current literature.

METHODS

A literature review was conducted using PubMed with the following search terms: Pacinian corpuscle hyperplasia, Pacinian corpuscle neuroma, Pacinioma, Pacinian corpuscle hypertrophy, and heterotopic Pacinian corpuscles. All case reports and case series were reviewed for histopathologic evidence of true Pacinian corpuscle hyperplasia. Cadaveric studies, cases without true Pacinian corpuscles, and noncutaneous cases were excluded from our analysis.

RESULTS

Sixty patients with Pacinian corpuscle hyperplasia of the hands and feet (65 cases, some with >1 location) were reviewed. The mean age of presentation was 49.5 years, and women accounted for 60% of cases. Pain was the most commonly reported symptom (55 of 65 cases; 84.6%). Forty-five cases (69.2%) were localized to a digit, most commonly the second digit (17 of 65 cases; 26.2%), and 18 of 65 cases (27.6%) affected the palm, primarily the distal palm. Surgical excision was curative in 50 of 65 cases (76.9%).

CONCLUSION

Although relatively uncommon, Pacinian corpuscle hyperplasia should be considered in the differential diagnosis of a tender nodule on the digit or distal palm, particularly after trauma.

Penile pacinian neurofibroma

Pacinian neurofibroma (PNF) is a lobulated benign neural tumor with prominent structures resembling pacinian bodies. These tumors most commonly occur in areas where normal pacinian bodies are found, such as the hands and feet. Although pacinian bodies are common in the penis, no cases of penile PNF have been reported to date. We present a case of PNF on the dorsal glans penis of a 47-year-old man. The lesion presented as a single flesh-colored papule and the biopsy showed a dermal neurofibroma consisting of bland spindle cells with wavy nuclei, without mitoses or atypia, and some nodular structures with a concentric arrangement and a pacinian appearance. Immunohistochemistry demonstrated positivity for CD34 and Vimetin and negativity for Epithelial Membrane Antigen (EMA). S100 was highly positive in the most central areas of the pacinian-like nodules, while the periphery and non-nodular parts of the neurofibroma were less intensively expressed.

A rare case of Pacinian corpuscle neuroma

The authors discuss an interesting case of a Pacinian corpuscle neuroma in the thumb of an elderly woman who presented with severe digital pain. The pain was initially attributed to osteoarthritis of the interphalangeal joint of the thumb. The clinical signs were very subtle. The patient had complete pain relief following excision of the tumour. Pacinian corpuscle neuromas are rare, with only about 70 cases reported in the literature. The histology, presenting features and associated conditions are discussed in detail. In addition to a neuroma or glomus tumour, Pacinian corpuscle hyperplasia should be considered in the differential diagnosis of digital or palmar pain of unknown etiology.