Psammomatous melanotic schwannoma. A new cutaneous marker for Carney's complex.
BACKGROUND
Noncutaneous psammomatous melanotic schwannoma has recently been reported as an unusual component of Carney's complex (myxomas, spotty pigmentation, and endocrinopathy). The most common locations for this lesion include peripheral nerve roots and the gastrointestinal tract.


METHODS
A cutaneous psammomatous melanotic schwannoma is reported in a patient with known Carney's complex. This neoplasm was pseudoencapsulated, with epithelioid to spindle-shaped cells and no nuclear atypia. Immunostaining was positive for S100 protein and vimentin, as well for HMB-45 antibody. Electron microscopy showed melanosomes in cytoplasmic processes of cells that were ensheathed by layers of reduplicated basal lamina.


CONCLUSIONS
Location in the superficial soft tissues is extremely unusual for psammomatous melanotic schwannomas. Recognition of this new cutaneous marker as a part of this complex may aid in identification of individuals at risk for cardiac myxomas. It is also important that this lesion is not mistaken for melanoma, given the strong HMB-45 positivity.
Utiger
C A
CA
Department of Pathology, University of Michigan Medical Center, Ann Arbor.
Headington
J T
JT
D000310:Adrenal Gland Neoplasms / Q000473:pathology; D000328:Adult; D003593:Cytoplasm / Q000648:ultrastructure; D005260:Female; D006801:Humans; D015603:Keratinocytes / Q000473:pathology; D008543:Melanins / Q000032:analysis; D008544:Melanocytes / Q000473:pathology; D009232:Myxoma / Q000473:pathology*; D009378:Neoplasms, Multiple Primary / Q000473:pathology*; D009442:Neurilemmoma / Q000473:pathology*; D010859:Pigmentation Disorders / Q000473:pathology; D009418:S100 Proteins / Q000032:analysis; D012878:Skin Neoplasms / Q000473:pathology*; D013577:Syndrome; D014746:Vimentin / Q000032:analysis
D008543:Melanins; D009418:S100 Proteins; D014746:Vimentin