Solitary intraosseous neurilemmoma of the tibia: review of intraosseous neurilemmoma and neurofibroma.

This is a case report of a 59-year-old woman with a neurilemmoma involving the tibia, a site not previously reported for this tumor. Neurilemmoma, a benign neoplasm which rarely involves bone, arises from the Schwann cells in the nerve sheath. It is a distinct pathological entity separate from solitary neurofibroma, and arises from the connective tissue coats of nerves, but which also involves bone. The incidence of the 2 types of nerve sheath tumors is obscured by the tendency of some authors to use the terms interchangeably. Forty-eight cases of true intraosseous neurilemmoma have been reported in the literature. Of 18 cases of solitary intraosseous neurofibroma primary in bone, all were in the jaw and 6 were malignant. The diagnosis of intraosseous neurilemmoma may be missed because of its rarity and roentgenologic appearance of cystic bone disease which is not distinctive except that it resembles other commonly encountered bone lesions. A positive diagnosis is based only on the microscopic pathology. Complete local resection generally produces an excellent result without recurrence.