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足底细胞性神经鞘瘤酷似结节性黑素瘤,避免误诊的陷阱。

Cellular Schwannoma Mimicking a Nodular Melanoma on the Sole of the Foot, an Avoidable Diagnostic Pitfall.

机构信息

Department of Dermatology, Hospital Universitario Virgen Macarena, Seville, Spain.

Department of Pathology, Hospital Universitario Virgen Macarena, Seville, Spain; and.

出版信息

Am J Dermatopathol. 2024 Sep 1;46(9):e79-e83. doi: 10.1097/DAD.0000000000002770. Epub 2024 Jun 20.

DOI:10.1097/DAD.0000000000002770
PMID:39150191
Abstract

We report a rare case of cellular schwannoma (CS) manifesting as an ulcerated nodular lesion, mimicking spindle cell melanoma on the sole of the foot. CS, a benign variant of schwannoma, typically occurs in deep soft tissues but can rarely present cutaneously. The diagnosis of CS heavily relies on histopathological examination and immunohistochemical staining for specific markers such as SOX10 and S100. In this case, initial clinical suspicion of nodular melanoma was confirmed on biopsy, which revealed a spindle cell neoplasm positive for SOX10 and negative for melanocytic markers. Misdiagnosis of nodular melanoma was averted through complete excision. CS diagnosis demands careful consideration due to its resemblance to other spindle cell neoplasms, especially melanoma. Meticulous histopathological evaluation and immunostaining are important to differentiate CS from similar lesions, ensuring accurate diagnosis and appropriate management. This report contributes valuable insights into the diagnostic challenges and management of CS, particularly in unusual cutaneous presentations.

摘要

我们报告了一例罕见的细胞性神经鞘瘤(CS)病例,其表现为足底溃疡性结节性病变,类似于梭形细胞黑色素瘤。CS 是神经鞘瘤的良性变异型,通常发生在深部软组织中,但也可罕见地发生在皮肤中。CS 的诊断主要依赖于组织病理学检查和免疫组织化学染色,以检测特定标志物,如 SOX10 和 S100。在本病例中,最初临床怀疑为结节性黑色素瘤,活检证实为梭形细胞肿瘤,SOX10 阳性,黑色素细胞标志物阴性。通过完全切除避免了误诊为结节性黑色素瘤。由于 CS 与其他梭形细胞肿瘤,尤其是黑色素瘤相似,因此需要仔细考虑 CS 的诊断。细致的组织病理学评估和免疫染色对于将 CS 与类似病变区分开来非常重要,以确保准确的诊断和适当的治疗。本报告为 CS 的诊断挑战和管理提供了有价值的见解,特别是在不常见的皮肤表现中。

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