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CASE REPORT |
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| Year : 2008 | Volume
: 53
| Issue : 1 | Page : 35-36 |
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| Myxoid neurofibroma: An unusual presentation |
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Rosa Maria Ponce-Olivera1, Andres Tirado-Sanchez1, Amelia Peniche-Castellanos1, Jorge Peniche-Rosado1, Patricia Mercadillo-Perez2
1 Service of Dermatology, Hospital General de México, Mexico
2 Department of Dermatopathology, Hospital General de México, Mexico
Correspondence Address:
Andres Tirado-Sanchez
Servicio de Dermatología, Hospital General de México, Dr. Balmis 148, Col. Doctores, Deleg. Cuauhtemoc, México, D.F, C.P. 06726
Mexico
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0019-5154.39742
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 Abstract | | |
Myxoid neurofibroma (MN) is a benign tumor of perineural cell origin, which is demonstrated with a positive immunohistochemical staining for S-100 protein. The most common locations of the MN are the face, shoulders, arms, periungual and in the feet. To our knowledge, this is the first time that a trunk location is reported. MN should be included in the differential diagnosis of tumors on this location.
Keywords: Myxoid neurofibroma, nerve sheath tumor, neurofibroma
How to cite this article:
Ponce-Olivera RM, Tirado-Sanchez A, Peniche-Castellanos A, Peniche-Rosado J, Mercadillo-Perez P. Myxoid neurofibroma: An unusual presentation. Indian J Dermatol 2008;53:35-6 |
How to cite this URL:
Ponce-Olivera RM, Tirado-Sanchez A, Peniche-Castellanos A, Peniche-Rosado J, Mercadillo-Perez P. Myxoid neurofibroma: An unusual presentation. Indian J Dermatol [serial online] 2008 [cited 2022 May 27];53:35-6. Available from: https://www.e-ijd.org/text.asp?2008/53/1/35/39742 |
| Introduction | |  |
Neurofibroma can present as a single lesion or be part of a neurofibromatosis. [1] Solitary neurofibroma can present as one of the following variants: cutaneous lipomatous, collagenous, epithelioid, granular, pigmented, dendritic cell and myxoid neurofibromas. [2]
We present the case of a myxoid neurofibroma (MN) of the trunk, which is a rare location of this tumor.
| Case Report | | |
A 44-year-old woman presented with a non-tender, slow-growing nodular plaque on the anterior trunk that appeared six years ago [Figure - 1]. She sought medical attention for cosmetic reasons.
The patient denied any past medical condition or consumption of medication. There were no drug allergic reactions. On physical examination, a 10 × 5-cm flesh-colored plaque on the anterior trunk was observed.
An incisional biopsy was taken. Gross examination shows a well-circumscribed lesion composed of spindle-shaped cells with wavy nuclei [Figure - 2]. A few mast cell and mucin were present. Immunohistochemical staining was positive for S-100 protein and negative for CD34. The diagnosis made was myxoid neurofibroma.
We scheduled a surgical excision that was incomplete and a few months later, a new lesion emerged, a new surgical procedure was programmed but the patient rejected it.
| Discussion | | |
Myxoid neurofibroma is a benign tumor of perineural cell origin, which is demonstrated with a positive immunohistochemical staining for S-100 protein. [3]
This tumor has a higher incidence in young adults. [4] It usually presents as a non-tender solitary nodule. [3]
The most common locations of the MN are the face, shoulders, arms, periungual and in the feet. [5],[6] To our knowledge, this is the first time that a trunk location has been reported.
MN is usually a solitary lesion, [1] as in our patient, however, they can be numerous and may recur following an incomplete initial excision.
Differential diagnosis includes intramuscular myxoma and myxoid dermatofibrosarcoma protuberans. The first one is negative to S-100; and in the second one, on histological examination, slender tumor cells with large, spindle-shaped nuclei are seen, as well as mitotic figures; a high cellularity and irregular, short, intersecting bands of tumor cells forming a storiform pattern are characteristic. [7],[8]
The usual first-line treatment is total excision of tumor, [9] but only for cosmetic or diagnostic reasons. Some reports have mentioned the danger of these tumors masquerading as malignancies (mainly neurofibrosarcoma or epithelioid sarcoma). [6]
To our knowledge, this is the first report of a MN on the trunk. MN should be included in the differential diagnosis of tumors at this location.
| References | | |
| 1. | Angervall L, Kindblom LG, Haglid K. Dermal nerve sheath myxoma. Cancer 1984;53: 1752-9.  [PUBMED] |
| 2. | Mrugala MM, Batchelor TT, Plotkin SR. Peripheral and cranial nerve sheath tumors. Curr Opin Neurol 2005;18:604-10. [PUBMED] [FULLTEXT] |
| 3. | Donofrio V, Passeretti U, Russo S. Neurothekeoma of the thumb: A case report. Tumori 1988;74:751-4. |
| 4. | Rosati L, Fratamico FC, Eusebi V. Cellular neurothekeoma. Appl Pathol 1986;4:186-91. |
| 5. | King DT, Barr RJ. Bizarre cutaneous neurofibromas. J Cutan Pathol 1980;7:21-31. [PUBMED] |
| 6. | Gmyrek RF, Beer R, Silvers DN. Periungual myxoid neurofibroma. Cutis 2002;69:54-6. |
| 7. | Charron P, Smith J. Intramuscular myxomas: A clinicopathologic study with emphasis on surgical management. Am Surg 2004;70:1073-7. [PUBMED] |
| 8. | Orlandi A, Bianchi L, Spagnoli LG. Myxoid dermatofibrosarcoma protuberans: Morphological, ultrastructural and immunohistochemical features. J Cutan Pathol 1998;25:386-93. [PUBMED] |
| 9. | Requena L. Benign neoplasm with neural differentiation. Am J Dermatol 1995;17:75-96. |
[Figure - 1], [Figure - 2] |
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