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DOI: 10.1055/s-0040-1712135
Neurothekeoma in the Axilla Causing Persistent Shoulder Pain: Case Report[∗]
Article in several languages: português | English
Abstract
Neurothekeomas, also known as neural sheath myxomas, are rare benign tumors of the neural sheath affecting most commonly the head, arms and shoulder of women in their 2nd and 3rd decades of life. Due to the low prevalence and undefined clinical picture, they are hardly considered in the initial differential diagnosis of skin tumors. We report the case of a 24 year-old woman who was seen in 2016 reporting > 1 year of moderate pain and limited mobility of her left shoulder. Clinical evaluation revealed restricted mobility of the affected shoulder and nuclear magnetic resonance imaging showed a T2-weighted contrast-enhanced multilobular mass in the quadrilateral area apparently invading the adjacent humeral cortical region. Histopathology of a needle sample material revealed loose fibroconnective tissue with no signs of invasion, mitosis or atypical figures. Successful surgical excision was performed and the diagnosis of neurothekeoma was confirmed after detailed histopathology, including immunohistochemistry. The patient was asymptomatic at 18 months of follow-up, with full recovery of shoulder movement and no signs of relapse.
∗ Study developed at the Orthopedics Service of the Hospital Geral de Fortaleza, Fortaleza, CE, Brazil.
Publication History
Received: 23 October 2019
Accepted: 02 March 2020
Article published online:
22 September 2020
© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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Referências
- 1 Fetsch JF, Laskin WB, Hallman JR, Lupton GP, Miettinen M. Neurothekeoma: an analysis of 178 tumors with detailed immunohistochemical data and long-term patient follow-up information. Am J Surg Pathol 2007; 31 (07) 1103-1114
- 2 Hornick JL, Fletcher CD. Cellular neurothekeoma: detailed characterization in a series of 133 cases. Am J Surg Pathol 2007; 31 (03) 329-340
- 3 Stratton J, Billings SD. Cellular neurothekeoma: analysis of 37 cases emphasizing atypical histologic features. Mod Pathol 2014; 27 (05) 701-710
- 4 Fetsch JF, Laskin WB, Miettinen M. Nerve sheath myxoma: a clinicopathologic and immunohistochemical analysis of 57 morphologically distinctive, S-100 protein- and GFAP-positive, myxoid peripheral nerve sheath tumors with a predilection for the extremities and a high local recurrence rate. Am J Surg Pathol 2005; 29 (12) 1615-1624
- 5 Plaza JA, Torres-Cabala C, Evans H, Diwan AH, Prieto VG. Immunohistochemical expression of S100A6 in cellular neurothekeoma: clinicopathologic and immunohistochemical analysis of 31 cases. Am J Dermatopathol 2009; 31 (05) 419-422
- 6 Sheth S, Li X, Binder S, Dry SM. Differential gene expression profiles of neurothekeomas and nerve sheath myxomas by microarray analysis. Mod Pathol 2011; 24 (03) 343-354
- 7 Campanati A, Brandozzi G, Sisti S, Bernardini ML, Offidani AM. Atypical neurothekeoma: a new case and review of the literature. J Cutan Pathol 2007; 34 (05) 435-437
- 8 Busam KJ, Mentzel T, Colpaert C, Barnhill RL, Fletcher CD. Atypical or worrisome features in cellular neurothekeoma: a study of 10 cases. Am J Surg Pathol 1998; 22 (09) 1067-1072