Department of Pathology and Laboratory Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, ON, Canada K1H 8L6.
Hum Pathol. 2013 Oct;44(10):2360-4. doi: 10.1016/j.humpath.2013.02.020. Epub 2013 May 21.
A 67-year-old woman with a history of breast cancer presented with a soft tissue mass at the site of a remote, non-neoplastic lumbar surgery. Excisional biopsy revealed a traumatic neuroma. Five years later she re-presented with a rapidly growing, tender nodule at the same site. An excisional biopsy was again performed and revealed a tumor composed of malignant epithelioid and spindle cells merging imperceptibly with residual traumatic neuroma. The malignant cells were positive for vimentin, S-100 and micropthalmia transcription factor. They were negative for cytokeratins, muscle markers, Melan-A, HMB45, glial fibrillary acidic protein, and myelin basic protein. Electron microscopy showed no melanosomes. The diagnosis of malignant peripheral nerve sheath tumor arising within a long-standing traumatic neuroma was rendered and represents a hitherto unreported origin of this rare, aggressive soft tissue sarcoma.
一位 67 岁的女性，有乳腺癌病史，在一处远处非肿瘤性腰椎手术部位出现软组织肿块。切除活检显示为创伤性神经瘤。五年后，她在同一部位再次出现快速生长、触痛的结节。再次进行切除活检，结果显示肿瘤由恶性上皮样和梭形细胞组成，与残留的创伤性神经瘤难以区分。恶性细胞表达波形蛋白、S-100 和微小脑转录因子。它们不表达细胞角蛋白、肌肉标志物、Melan-A、HMB45、胶质纤维酸性蛋白和髓鞘碱性蛋白。电子显微镜下未见黑色素体。诊断为长期创伤性神经瘤内发生的恶性外周神经鞘瘤，这是这种罕见侵袭性软组织肉瘤迄今为止尚未报道的起源。
