Multiple cutaneous neuromas: A case report
Keywords:
Multiple idiopathic cutaneous neuromas, multiple endocrine neoplasia 2b syndrome, palisaded encapsulated neuromaAbstract
A palisaded encapsulated neuroma (PEN) is a benign nerve sheath tumor, which is classified as a true neuroma based on the ratio (1:1) of axons to Schwann cells. This type of neuroma typically occurs as a solitary papular lesion, with a predilection for the central area of the face. Multiple mucosal neuromas are often associated with multiple endocrine neoplasia type 2b (MEN2b) and may be related to PTEN hamartoma tumor syndrome (PHTS). Multiple idiopathic cutaneous neuromas are unusual events, which occur spontaneously. We describe the case of a 14-year-old boy who presented with an eight-year history of multiple asymptomatic nodules. The number of nodules had increased over time. Prior to presenting to the clinic, histopathological analyses of three skin biopsy specimens had revealed similar findings, showing well-defined encapsulated spindle-shaped tumor cells in interlacing fascicles, with artefactual clefts. An immunohistochemical analysis revealed findings consistent with a diagnosis of PEN. Given the clinical presentation and the results of the histological analyses, a diagnosis of multiple cutaneous neuromas was established. Further endocrine work-up revealed the absence of MEN2b features.
References
2. Schaffer JV, Kamino H, Witkiewicz A, McNiff JM, Orlow SJ. Mucocutaneous neuromas: an underrecognized manifestation of PTEN hamartoma-tumor syndrome. Arch Dermatol 2006; 142: 625-32.
3. Moore RL, White CR. Multiple palisaded encapsulated neuromas in a child without other associated abnormalities. J Am Acad Dermatol 2010;62:358-9.
4. Liu GY, Song H, Xu XL. Multiple palisaded encapsulated neuromas in siblings: A case report and review of the published work. J Dermatol 2016;43:560-3.
5. Holm TW, Prawer SE, Sahl WJ, Jr., Bart BJ. Multiple cutaneous neuromas. Arch Dermatol 1973;107:608-10.
6. Camacho CP, Hoff AO, Lindsey SC, Signorini PS, Valente FO, Oliveira MN, et al. Early diagnosis of multiple endocrine neoplasia type 2B: a challenge for physicians. Arq Bras Endocrinol Metabol 2008;52:1393-8.
7. Lee MJ, Chung KH, Park JS, Chung H, Jang HC, Kim JW. Multiple Endocrine Neoplasia Type 2B: Early Diagnosis by Multiple Mucosal Neuroma and Its DNA Analysis. Ann Dermatol 2010; 22: 452-5.
8. Misago N, Joh K, Soejima H, Narisawa Y. The possibility that multiple mucocutaneous (palisaded encapsulated and nonencapsulated) neuromas may be a distinct entity. JAMA Dermatol 2013; 149: 498-500.
9. Truchot F, Grezard P, Wolf F, Balme B, Perrot H. Multiple idiopathic mucocutaneous neuromas: a new entity? Br J Dermatol 2001; 145: 826-9.
10. Guillet G, Gauthier Y, Tamisier JM, et al. Linear cutaneous neuromas (dermatoneurie en stries): a limited phakomatosis with striated pigmentation corresponding to cutaneous hyperneury(featuring multiple endocrine neoplasia syndrome?). J Cutan Pathol 1987;14:43-8.
11. Baykal C, Buyukbabani N, Boztepe H, Barahmani N, Yazganoglu KD. Multiple cutaneous neuromas and macular amyloidosis associated with medullary thyroid carcinoma. J Am Acad Dermatol 2007;56:S33-7.
12. Halder C, Sen S, Gangopadhyay A, Bala S. Zosteriform palisaded encapsulated neuroma: an unusual presentation. Indian J Dermatol 2013;58:492.
13. Lee MS, Lee JD, Cho SH, Kim HS. Palisaded Encapsulated Neuroma in a Zosteriform Distribution. Indian J Dermatol 2016;61:126.
14. Omori Y, Tanito K, Ito K, Itoh M, Saeki H, Nakagawa H. A pediatric case of multiple palisaded encapsulated neuromas of the palms and soles. Pediatr Dermatol 2014;31:e107-9.
15. Jokinen CH, Ragsdale BD, Argenyi ZB. Expanding the clinicopathologic spectrum of palisaded encapsulated neuroma. J Cutan Pathol 2010;37:43-8.
16. Reed RJ, Fine RM, Meltzer HD. Palisaded, encapsulated neuromas of the skin. Arch Dermatol 1972;106:865-70.
17. Kossard S, Kumar A, Wilkinson B. Neural spectrum: palisaded encapsulated neuroma and verocay body poor dermal schwannoma. J Cutan Pathol 1999;26:31-6.
18. Argenyi ZB. Immunohistochemical characterization of palisaded, encapsulated neuroma. J Cutan Pathol 1990; 17: 329-35.
19. Misago N, Toda S, Narisawa Y. The relationship between palisaded encapsulated neuroma and the mucocutaneous neuroma seen in multiple endocrine neoplasia 2b syndrome: a histopathologic and immunohistochemical study. Am J Dermatopathol 2014;36:562-9.
20. Dover JS, From L, Lewis A. Palisaded encapsulated neuromas. A clinicopathologic study. Arch Dermatol 1989;125:386-9.
21. Raue F, Frank-Raue K. Multiple endocrine neoplasia type 2: 2007 update. Horm Res 2007; 68: 101-4.
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