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Neuroblastoma-like neurilemoma
J R Goldblum1, T F Beals, S W Weiss
1Department of Pathology, University of Michigan Medical Center, Ann Arbor.
The American Journal of Surgical Pathology
|March 1, 1994
Summary
Three superficial soft tissue tumors initially mimicking neuroblastoma were diagnosed as schwannomas. Immunohistochemistry confirmed S-100 protein expression, aiding accurate diagnosis of these rare neurilemomas.
Area of Science:
- Surgical Pathology
- Oncology
- Dermatopathology
Background:
- Neurilemomas, benign peripheral nerve sheath tumors, can rarely present in superficial soft tissues.
- Distinguishing these from small round blue cell tumors like neuroblastoma is crucial for appropriate management.
Observation:
- Three cases of superficial soft tissue neurilemoma presented with features mimicking neuroblastoma.
- Histologically, tumors showed small, round, hyperchromatic cells with scant cytoplasm, forming perivascular or giant rosettes.
Findings:
- Immunohistochemistry revealed strong, diffuse S-100 protein expression in all cases.
- Absence of neurofilament protein, PGP, and synaptophysin supported schwannoma over neuroblastic tumors.
- Ultrastructural analysis showed slender cytoplasmic processes with basal lamina, characteristic of schwannoma.
Implications:
- Accurate diagnosis of superficial soft tissue neurilemoma is essential to avoid misclassification as a malignant neuroblastic tumor.
- Immunohistochemistry, particularly S-100 protein staining, is vital for differentiating these entities.
- Conservative surgical excision appears effective, with no recurrence observed in these cases.