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A rare case of atypical cellular neurothekeoma in a 68-year-old woman


Mertz, K D; Mentzel, T; Grob, M; Pfaltz, M; Kempf, W (2009). A rare case of atypical cellular neurothekeoma in a 68-year-old woman. Journal of Cutaneous Pathology, 36(11):1210-1214.

Abstract

Cellular neurothekeoma is a benign dermal lesion of uncertain differentiation. The atypical variant of cellular neurothekeoma, characterized by features such as large size, deep penetration, diffusely infiltrative borders, vascular invasion, high mitotic rate and marked cytologic pleomorphism, has been very rarely reported in the literature. We present the clinical, histopathological and immunohistochemical profile of a new case of atypical cellular neurothekeoma in a 68-year-old female patient who was diagnosed with ductal breast carcinoma in situ before. An erythematous painless papule arose in her right breast, and tentative clinical diagnosis was orientated toward skin metastasis of breast cancer or fibroma. Upon histological examination, the lesion showed the histological and immunohistochemical features of atypical variant of cellular neurothekeoma with high mitotic rate, marked cellular pleomorphism and penetration into subcutaneous fat. A further unusual feature in our patient was her age, because she is the oldest patient reported in the literature with diagnosis of atypical cellular neurothekeoma so far. Prognosis remains uncertain because only few cases of atypical cellular neurothekeoma have been reported in the literature, with a very limited follow-up time. Our report contributes to a better characterization of the clinical and morphologic features of atypical cellular neurothekeoma.

Cellular neurothekeoma is a benign dermal lesion of uncertain differentiation. The atypical variant of cellular neurothekeoma, characterized by features such as large size, deep penetration, diffusely infiltrative borders, vascular invasion, high mitotic rate and marked cytologic pleomorphism, has been very rarely reported in the literature. We present the clinical, histopathological and immunohistochemical profile of a new case of atypical cellular neurothekeoma in a 68-year-old female patient who was diagnosed with ductal breast carcinoma in situ before. An erythematous painless papule arose in her right breast, and tentative clinical diagnosis was orientated toward skin metastasis of breast cancer or fibroma. Upon histological examination, the lesion showed the histological and immunohistochemical features of atypical variant of cellular neurothekeoma with high mitotic rate, marked cellular pleomorphism and penetration into subcutaneous fat. A further unusual feature in our patient was her age, because she is the oldest patient reported in the literature with diagnosis of atypical cellular neurothekeoma so far. Prognosis remains uncertain because only few cases of atypical cellular neurothekeoma have been reported in the literature, with a very limited follow-up time. Our report contributes to a better characterization of the clinical and morphologic features of atypical cellular neurothekeoma.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2009
Deposited On:16 Dec 2009 08:28
Last Modified:05 Apr 2016 13:38
Publisher:Wiley-Blackwell
ISSN:0303-6987
Additional Information:The definitive version is available at www.blackwell-synergy.com
Publisher DOI:https://doi.org/10.1111/j.1600-0560.2009.01261.x
PubMed ID:19469878

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