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Neurothekeoma in the Axilla Causing Persistent Shoulder Pain: Case Report.

Christine Maria Muniz Silva1, João Paulo Uchoa Fontenele2, Jailson Rodrigues Lopes3

  • 1Serviço de Ortopedia, Hospital Geral de Fortaleza, Fortaleza, CE, Brasil.

Revista Brasileira De Ortopedia
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Summary

Neurothekeomas, rare neural sheath tumors, can cause shoulder pain and limited mobility. Surgical removal confirmed the diagnosis, leading to full recovery and symptom resolution in a young woman.

Keywords:
neurothekeomashouldertumors

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Area of Science:

  • Oncology
  • Dermatology
  • Pathology

Background:

  • Neurothekeomas, also known as neural sheath myxomas, are rare benign tumors.
  • They commonly affect women in their second and third decades, often presenting in the head, arms, and shoulder.
  • Their low prevalence and vague symptoms can delay diagnosis, making them overlooked in initial skin tumor assessments.

Purpose of the Study:

  • To report a case of neurothekeoma in a young woman presenting with shoulder pain and restricted mobility.
  • To highlight the diagnostic challenges and confirm the histopathological diagnosis of neurothekeoma.
  • To demonstrate the successful surgical management and long-term outcome of this rare tumor.

Main Methods:

  • Clinical evaluation of a 24-year-old woman with a year-long history of left shoulder pain and limited mobility.
  • Magnetic resonance imaging (MRI) to visualize the shoulder mass.
  • Needle biopsy for initial histopathology, followed by surgical excision and detailed histopathological analysis, including immunohistochemistry.

Main Results:

  • MRI revealed a multilobular mass in the quadrilateral area of the shoulder, appearing to invade the humeral cortex.
  • Initial needle biopsy showed benign fibroconnective tissue without signs of malignancy.
  • Post-surgical histopathology confirmed the diagnosis of neurothekeoma, and the patient experienced full recovery with no relapse at 18 months.

Conclusions:

  • Neurothekeoma should be considered in the differential diagnosis of shoulder masses, especially in young women.
  • Accurate diagnosis requires thorough histopathological examination, including immunohistochemistry.
  • Surgical excision is an effective treatment for neurothekeoma, leading to favorable long-term outcomes.