Published rep orts of benign nerve sheath tum ors of the laryn x are ex treme ly rare. Because these tum ors represent a potential threat to the airway, p rompt diagnosis and treatm ent are vital. We repor t a case of a neurilemmoma that arose from the right aryteno id mu scl e adj acent to the arytenoid ca rtilage. The mass was comp lete ly excised, and no recu rrence was obse rved durin g fo llow-up. We discuss the diagn osis and man agement of th is rare tum or:
A 63-year-old man, who was a kidney transplant recipient, presented with a 6-month history of a painful ulcer on his right shin. The transplant had been complicated by human leucocyte antigen mismatch and cytomegalovirus infection. His regular medications included oral tacrolimus, prednisolone, valganciclovir and co-trimoxazole.On physical examination, an ulcer, 1 cm 2 in size with a bluish edge, was seen on the lateral aspect of the patient's right shin. A clinical diagnosis of pyoderma gangrenosum (PG) was made, and the inflamed ulcer edge settled quickly with topical clobetasol proprionate 0.05% cream. However, over the following 8 months, the ulcer slowly increased in size with central overgranulation. Biopsy confirmed granulation tissue (Fig. 1). At 13 months, the inflamed edge returned (Fig. 2a) and was treated with topical clobetasol proprionate 0.05% cream and doxycycline 100 mg once daily as an anti-inflammatory. The ulcer failed to respond, and at 16 months a fluctuant purple nodule developed adjacent to the ulcer, followed by a rapid succession of ulcers and purple nonblanching papules and nodules (Fig. 2b).
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