Amita K, Rajani T
From the Department of Pathology, Adichunchanagiri Institute of Medical Sciences, Adichunchanagiri University, BG Nagara, Nagamangala Taluk, Mandya, Karnataka, India.
Indian J Dermatol. 2025 Mar-Apr;70(2):97-101. doi: 10.4103/ijd.ijd_584_23. Epub 2025 Feb 27.
Epithelioid morphology spawns myriad of benign and malignant tumors into differential diagnoses, which include epithelioid sarcoma, malignant melanoma, epithelioid malignant peripheral nerves sheath tumor, epithelioid hemangioendothelioma, myoepithelioma, etc. Epithelioid schwannoma (ES), especially the atypical variant has not received much attention in literature. Conclusive diagnosis, important for accurate management is, however, challenging. We describe a case of atypical ES in a 24-year-old female. On clinical and radiological examination, a provisional diagnosis of vascular malformation was made. Atypical epithelioid ESs are rare, but it is important to be aware of this variant to avoid misdiagnosis with other malignant epithelioid tumors. Apart from clinical and morphological features, immunohistochemistry aids in arriving at a decisive diagnosis. Perineurium-like capsule, circumscription, oblong shape of the lesion, and hyalinized blood vessels are pointers toward shwannomatous differentiation of this tumor.
上皮样形态会引发多种良恶性肿瘤的鉴别诊断，其中包括上皮样肉瘤、恶性黑色素瘤、上皮样恶性外周神经鞘瘤、上皮样血管内皮瘤、肌上皮瘤等。上皮样神经鞘瘤（ES），尤其是非典型变体，在文献中并未受到太多关注。然而，对于准确治疗至关重要的确诊却具有挑战性。我们描述了一例24岁女性的非典型ES病例。经临床和影像学检查，初步诊断为血管畸形。非典型上皮样ES很罕见，但了解这种变体以避免与其他恶性上皮样肿瘤误诊很重要。除了临床和形态学特征外，免疫组织化学有助于做出决定性诊断。类神经束膜样包膜、边界清晰、病变呈椭圆形以及血管玻璃样变是该肿瘤呈神经鞘瘤样分化的指标。
