ORAL NERVE SHEATH MYXOMA: Report of a Case with Findings of Ultrastructural and Immunohistochemical Studies

Yamamoto, Hirotsugu; Kawana, Tomonori

doi:10.1111/j.1440-1827.1988.tb01079.x

Cited by 18 publications

(17 citation statements)

References 14 publications

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“…Currently, there is equal support for the origin of NT as "Schwann cell" (19) and "perineural cell" (20). The presence of a strong immunoreactivity for S-100 protein and NSE supports the theory that the tumor originats from Table 1: Clinicopathological characteristics in the present cases of oral neurothekeoma "Schwann cell" (13,14,19,21). In contrast, lack of the immunoreactivity for S-100 protein and EMA in this tumor may indicate a "perineural cell" origin (20).…”

Section: Discussionsupporting

confidence: 60%

“…Mincer and Spears (7) had first reported a case in the tongue as NT in the oral cavity. To date, 16 cases (17 lesions) of intraoral NTs have been reported (2,4,(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). The details of the clinicopathological characteristics in the previous cases and our current cases of intraoral NTs were summarized in Table 1 and 2.…”

Section: Discussionmentioning

confidence: 89%

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Neurothekeoma of the Oral Cavity: Report of two cases of a distinctive variant and review of the literature.

et al. 2001

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Oral Med Pathol 6(2001) 95 IntroductionNeurothekeoma (NT) including nerve sheath myxoma (NSM), is a rare neoplasm arising from the endoneurium of the peripheral nerves. In 1969, Harkin and Reed (1) were the first to report on this tumor in the dermis, and they termed it "myxoma of the nerve sheath". The tumor was characterized by a lobular proliferation of myxomatous tissue separated by fibrous septa. Subsequently, Gallager and Helwig (2) reported 53 cases of a benign tumor of the dermis and subcutaneous tissue that was histologically suggestive of "Schwann cell tumor", which they called NT. Since then, the differential diagnosis between NSM and NT has been controversial. Generally, the prevailing view has been that NSM and NT are predominantly myxoid and cellular variants of the same tumor (3), and Pulitzer and Reed (4) accepted these two lesions as synonymous in a broad sense. However, Laskin et al. (5) stated that NSM is only a hypocellular variant in the myxoid type of NT. In 1996, the World Health Organization "Histological Typing of Skin Tumours" (6) stated that NSM may represent a variant of NT with increased mucin deposition associated with greater age, and NT may be subdivided into cellular and myxoid variants. Recently, immunohistochemical analysis has been performed to determine the subdivision of NT, but there is no consistency of immunoreaction in some cases. Thus, the precise relationship between NSM and NT has not yet been completely established due to disagreement among investigators. NT often develops in the dermis and subcutis of the face, extremities, trunk and the shoulders (6), and very rarely in underlying mucous membranes. Previously, only 16 cases of intraoral NT have been reported (2,4,(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). We describe the clinical and pathologic features of two cases of NT as a distinctive variant: a mixed variant arising in the buccal mucosa and a myxoid variant arising in the inferior surface of the tongue. In addition, previously reported intraoral lesions of this tumor are reviewed. Case Reports Case 1A 59-year-old man visited our outpatient clinic on May 20, 1992, with a chief complaint of a gradually enlarging mass in the buccal mucosa. The patient had repeated formation of a submucosal hematoma in the left buccal mucosa during the prvious two years, due to biting. Physical examination revealed a pedunculated polypous mass measuring 10¥14¥7 mm in size on the left buccal mucosa corresponding to the bite-surface of the Neurothekeoma of the Oral Cavity: Report of two cases of a distinctive variant and review of the literature

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confidence: 60%

Section: Discussionmentioning

confidence: 89%

Neurothekeoma of the Oral Cavity: Report of two cases of a distinctive variant and review of the literature.

et al. 2001

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“…25,37,40,41 Pulitzer and Reed fostered the belief that neurothekeoma and nerve sheath myxoma were the same clinicopathologic entity, 22,33 and this opinion has been supported by others. 1,4,16,20,24 However, evidence has mounted over the years that these are, in fact, distinct and unrelated processes, 3,8,25,37,40,42 and corroboration of this view has recently been presented in a large series of true nerve sheath myxomas.…”

Section: Discussionmentioning

confidence: 92%

Neurothekeoma: An Analysis of 178 Tumors With Detailed Immunohistochemical Data and Long-term Patient Follow-up Information

Fetsch¹,

Laskin

Hallman

et al. 2007

American Journal of Surgical Pathology

207

306

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This report describes the clinicopathologic findings in 176 patients who presented with 178 tumors currently referred to as neurothekeomas. Our study group included 64 males and 112 females, ranging from 20 months to 85 years old at the time of their first surgical procedure (median age: 17 y). Twenty-four percent of patients were or=30 years of age at initial diagnosis. The patients typically presented with a solitary, superficial, slow-growing, and relatively asymptomatic mass in the 0.3 to 2.0 cm size range. One patient had multiple tumors. More than 75% of the lesions involved the head (n=63), upper extremities (n=44), and shoulder girdle (n=27) regions. The tumors were evident a few weeks to 4 years (median duration: approximately 7 mo) before surgical resection was sought. Histologically, the lesions involved the dermis and/or subcutis, and they formed multinodular masses with varying amounts of myxoid matrix and peripheral fibrosis. On the basis of the amount of myxoid matrix, the tumors were subclassified as cellular (n=63), mixed (n=67), or myxoid (n=48). All cases had spindled and epithelioid mononuclear neoplastic cells with relatively abundant cytoplasm and indistinct cell borders. The majority of cases also had occasional multinucleated tumor cells. The lesional cells had a strong tendency for whorled growth, and oftentimes, focal fascicular growth was also present. Nuclear atypia was minimal in 62 cases, mild in 73 cases, at least focally moderate in 41 cases, and focally marked in 2 cases. Mitotic activity ranged from 0 to 124 mitotic figures/25 wide-field high power fields (WHPFs) (median mitotic count: 4 mitotic figures/25WHPFs). Twenty-five lesions had >10 mitotic figures/25WHPFs. A total of 16 cases (9%) had atypical mitotic figures. Osteoclastlike giant cells were detected in 39% of cases. Immunoreactivity was typically present for vimentin, NKI/C3, CD10, microphthalmia transcription factor, and PGP9.5, and focal reactivity was sometimes noted for smooth muscle actin and CD68. All tumors tested were negative for S100 protein, glial fibrillary acidic protein, and Melan A. The overwhelming majority of cases had involvement of the tissue margins. A complete follow-up record is available for 71 patients (40.3%) with follow-up intervals ranging from 3 years 2 months to 34 years 9 months (median: 17 y 9 mo). Limited or incomplete follow-up information is also available for an additional 14 patients with follow-up intervals ranging from weeks to approximately 10 years (median: 5 mo). Regrowth of tumor after biopsy or local excision was reported in 13 patients, one of whom had 2 recurrences. However, because of the nature of our consultation practice and a tendency for clinicians to specifically send us cases with a complex clinical course, this is believed an overestimation of the true recurrence rate. Neurothekeomas are morphologically and immunohistochemically distinct from true nerve sheath myxomas. An origin from fibroblastic cells with the abili...

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“…They consider NSM a multilobulated, myxoid neoplasm composed of fusiform and stellate cells. Immunohistochemically, the tumor cells are S-100 positive, 2,[4][5][6]11,15,21,23 and ultrastructural study shows interdigitating processes and continuous or discontinuous external lamina. 2,3,5,15,21,22 Some use the term NT for less myxoid and more cellular lesions, formed by fusiform and epithelioid cells that, in contrast to NSM, are negative for S-100 and ultrastructurally do not exhibit Schwann cell differentiation, showing fibroblast and undifferentiated polygonal cells.…”

Section: Discussionmentioning

confidence: 95%

“…19 They also have been found in extracutaneous locations, such as intraspinal space, 15 intracranial space, 16 external auditory canal 24 and oral mucosa. 11,14,18,20,21,23 Scheithauer et al 19 differentiated between NSM and NT on the basis of the histopathologic, immunohistochemical and ultrastructural findings. They consider NSM a multilobulated, myxoid neoplasm composed of fusiform and stellate cells.…”

Section: Discussionmentioning

confidence: 99%

Fine Needle Aspiration Cytology of Neurothekeoma

Vinagre¹,

Martín²,

Barrios³

et al. 2003

Acta Cytologica

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ORAL NERVE SHEATH MYXOMA: Report of a Case with Findings of Ultrastructural and Immunohistochemical Studies

Cited by 18 publications

References 14 publications

Neurothekeoma of the Oral Cavity: Report of two cases of a distinctive variant and review of the literature.

Neurothekeoma of the Oral Cavity: Report of two cases of a distinctive variant and review of the literature.

Neurothekeoma: An Analysis of 178 Tumors With Detailed Immunohistochemical Data and Long-term Patient Follow-up Information

Fine Needle Aspiration Cytology of Neurothekeoma

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