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Palisaded encapsulated neuroma
Other Resources UpToDate PubMed

Palisaded encapsulated neuroma

Contributors: Juhi R. Kuchroo, Susan Burgin MD
Other Resources UpToDate PubMed


Palisaded encapsulated neuroma (PEN, also known as solitary circumscribed neuroma) is a slow-growing, benign, solitary, spontaneous papule secondary to the proliferation of nerve fibers encapsulated within the perineurium (hence its encapsulation). There is no clear etiology. Often PEN favors the face (including the oral cavity and nasal fossa), particularly near a mucocutaneous junction, but it can also appear on the neck, genitalia, trunk, extremities, hands, and feet. It is most common in adults over the age of 40 and has no significant sex predominance. There is typically no inciting trauma.

Rare cases of multiple PENs have been reported.


D36.10 – Benign neoplasm of peripheral nerves and autonomic nervous system, unspecified

404019003 – Palisaded encapsulated neuroma

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Differential Diagnosis & Pitfalls

  • Nodular basal cell carcinoma (BCC)
  • Common acquired nevus
  • Angiofibroma
  • Epidermoid cyst
  • Solitary neurofibroma (including Plexiform neurofibroma) – may be associated with Neurofibromatosis, also known as von Recklinghausen disease; can be distinguished histologically
  • Neurilemmoma (including plexiform schwannoma) – can be distinguished histologically
  • Traumatic neuroma – can be distinguished histologically
  • Cutaneous leiomyoma / Cutaneous angioleiomyoma – can be distinguished histologically
  • Benign appendageal tumors – Trichoblastoma, Trichilemmoma, Trichoepithelioma, Trichofolliculoma, Chondroid syringoma, Eccrine spiradenoma, Cylindroma, Pilomatricoma
  • Amelanotic melanoma

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Last Reviewed:12/13/2018
Last Updated:08/15/2021
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Palisaded encapsulated neuroma
A medical illustration showing key findings of Palisaded encapsulated neuroma : Face
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