Department of Plastic and Reconstructive Surgery, Soonchunhyang University Gumi Hospital, Gumi 39371, Republic of Korea.
Department of Pathology, Soonchunhyang University Cheonan Hospital, Cheonan 31538, Republic of Korea.
Medicina (Kaunas). 2024 Jul 24;60(8):1200. doi: 10.3390/medicina60081200.
Neurofibromas, rare benign tumors of the peripheral nerve sheath, present diagnostic challenges, particularly in diabetic patients with toe ulcers. This case involves a 55-year-old female with type 2 diabetes mellitus who developed an enlarging ulcer on her right second toe. The initial evaluation suggested a diabetic ulcer; however, advanced imaging revealed a mass-like lesion. Partial excision and biopsy confirmed a neurofibroma with spindle cells within the myxoid stroma and S100 protein expression. One month later, total excision and Z-plasty reconstruction were performed under general anesthesia. The patient's postoperative recovery was uneventful, and the patient was discharged without complications. Follow-up revealed successful healing with no recurrence or functional issues. This case highlights the importance of considering neurofibromas in the differential diagnosis of diabetic toe ulcers to avoid misdiagnosis and ensure appropriate management.
神经纤维瘤是一种罕见的外周神经鞘良性肿瘤，具有诊断挑战性，尤其是在伴有脚趾溃疡的糖尿病患者中。本病例涉及一名 55 岁女性，患有 2 型糖尿病，她的右脚第二脚趾出现了一个不断增大的溃疡。最初的评估提示为糖尿病性溃疡；然而，高级影像学检查显示存在块状病变。部分切除和活检证实为神经纤维瘤，瘤体内有梭形细胞和黏液样基质，且 S100 蛋白表达阳性。一个月后，在全身麻醉下进行了全部切除和 Z 成形术重建。患者术后恢复顺利，无并发症出院。随访显示愈合成功，无复发或功能问题。本病例强调了在糖尿病性脚趾溃疡的鉴别诊断中考虑神经纤维瘤的重要性，以避免误诊并确保适当的治疗。
