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Myxoid perineurioma: an entity with many mimics
Seo Hyun Kim1, Kiley Fagan, Susan B Dorsey
1Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA. elinak@vt.edu,djgrider@carilionclinic.org.
Dermatology Online Journal
|April 11, 2023
Summary
A rare myxoid perineurioma, a skin tumor, was identified in a patient. This diagnosis was confirmed through immunohistochemistry, highlighting the tumor
Area of Science:
- Dermatopathology
- Surgical Pathology
Background:
- Cutaneous tumors can present with diverse histopathological features.
- Differentiating benign spindle cell neoplasms requires careful evaluation of immunohistochemical markers.
Observation:
- A 0.6cm flesh-colored, rubbery papule on the left thigh was biopsied.
- Histopathology revealed a dermal myxoid tumor with spindled cells and numerous mast cells.
Findings:
- Immunohistochemistry excluded myxoid neurofibroma (S100 and Sox10 negative).
- Spindle cells were positive for epithelial membrane antigen (EMA) and CD34, supporting myxoid perineurioma.
- Mast cells demonstrated cytoplasmic and nuclear positivity for microphthalmia transcription factor (MiTF).
Implications:
- This case expands the understanding of myxoid perineurioma.
- The MiTF positivity in mast cells is an interesting finding requiring further investigation.
- Definitive diagnosis relies on a combination of morphology and immunohistochemistry.
