Superficial malignant peripheral nerve sheath tumor with overlying intradermal melanocytic nevus mimicking spindle cell melanoma
Christopher R. Jackson
Department of Pathology, VCU School of Medicine, Richmond, VA, USA
Search for more papers by this authorEugen C. Minca
Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
Search for more papers by this authorJyoti P. Kapil
Department of Pathology, VCU School of Medicine, Richmond, VA, USA
Search for more papers by this authorCorresponding Author
Steven Christopher Smith
Department of Pathology, VCU School of Medicine, Richmond, VA, USA
Steven Christopher Smith, MD, PhD,
Department of Pathology, Virginia Commonwealth University School of Medicine, 1200 E Marshall Street Gateway 6–205, PO Box 980662, Richmond, VA 23226, USA
Tel: +804 828 4918
Fax: +804 828 8733
e-mail: [email protected]
Search for more papers by this authorSteven D. Billings
Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
Search for more papers by this authorChristopher R. Jackson
Department of Pathology, VCU School of Medicine, Richmond, VA, USA
Search for more papers by this authorEugen C. Minca
Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
Search for more papers by this authorJyoti P. Kapil
Department of Pathology, VCU School of Medicine, Richmond, VA, USA
Search for more papers by this authorCorresponding Author
Steven Christopher Smith
Department of Pathology, VCU School of Medicine, Richmond, VA, USA
Steven Christopher Smith, MD, PhD,
Department of Pathology, Virginia Commonwealth University School of Medicine, 1200 E Marshall Street Gateway 6–205, PO Box 980662, Richmond, VA 23226, USA
Tel: +804 828 4918
Fax: +804 828 8733
e-mail: [email protected]
Search for more papers by this authorSteven D. Billings
Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
Search for more papers by this authorAbstract
Malignant peripheral nerve sheath tumors are rare soft tissue sarcomas with histological and immunohistochemical similarities to spindle cell melanoma. Although spindle cell melanoma is significantly more common, both tumors may express S100 and lack staining for HMB-45, Melan-A or MITF. Here we present a case of superficial malignant peripheral nerve sheath tumor with diffuse S100 positivity arising in a subtle neurofibroma in close proximity to an intradermal melanocytic nevus. This configuration had led to prior misdiagnosis as a desmoplastic melanoma arising in the nevus and to sentinel lymph node biopsy. Identification of the background neurofibroma, as well as CD34 positivity raised consideration of a low grade malignant peripheral nerve sheath tumor, which was confirmed via observation of Schwannian differentiation on electron microscopy. The importance of distinguishing these two tumors is stressed owing to the difference in management.
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