Orbital and myocardial metastases of a primary pulmonary melanotic schwannoma.
We present the case of a 60-year-old man with a primary pulmonary melanotic schwannoma treated with surgery and who developed an orbital and myocardial relapse 2 years after the initial diagnosis. Melanotic schwannomas are rare pigmented tumours that tend to arise from the peripheral nerves near the midline. A primary lung presentation, as in our case, is extremely rare. In more than half of cases, the Carney triad of myxomas of the heart, skin and breast, spotty pigmentation and endocrine hyperactivity is present. A thorough pathological study is pivotal for a correct diagnosis. The main differential diagnosis is with metastases of malignant melanoma. The biological behaviour is unpredictable. Treatment should include radical surgery if possible; the role of chemotherapy and radiotherapy is uncertain due to the rarity of the tumour.
Díaz Beveridge
Robert
R
Medical Oncology Unit, University Hospital La Fe, Valencia, Spain. diaz_rob@gva.es
Richart Aznar
Paula
P
Núñez Lozano
Cornelio
C
Chirivella Casanova
Melitina
M
Corbellas Aparicio
Miguel
M
Montalar Salcedo
Joaquín
J
D006338:Heart Neoplasms / Q000556:secondary*; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D009442:Neurilemmoma / Q000473:pathology / Q000556:secondary*; D009918:Orbital Neoplasms / Q000556:secondary*