title: Malignant peripheral nerve sheath tumor arising in a traumatic neuroma: a case report.
abstract: A 67-year-old woman with a history of breast cancer presented with a soft tissue mass at the site of a remote, non-neoplastic lumbar surgery. Excisional biopsy revealed a traumatic neuroma. Five years later she re-presented with a rapidly growing, tender nodule at the same site. An excisional biopsy was again performed and revealed a tumor composed of malignant epithelioid and spindle cells merging imperceptibly with residual traumatic neuroma. The malignant cells were positive for vimentin, S-100 and micropthalmia transcription factor. They were negative for cytokeratins, muscle markers, Melan-A, HMB45, glial fibrillary acidic protein, and myelin basic protein. Electron microscopy showed no melanosomes. The diagnosis of malignant peripheral nerve sheath tumor arising within a long-standing traumatic neuroma was rendered and represents a hitherto unreported origin of this rare, aggressive soft tissue sarcoma.
authors.affiliation: Department of Pathology and Laboratory Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, ON, Canada K1H 8L6.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Kos
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Robertson
authors.forename: Bibianna M
authors.initials: BM
authors.lastname: Purgina
authors.forename: Shailendra
authors.initials: S
authors.lastname: Verma
authors.forename: Denis H
authors.initials: DH
authors.lastname: Gravel
mesh_terms: D000368:Aged; D015622:Epithelioid Cells / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D016609:Neoplasms, Second Primary; D018317:Nerve Sheath Neoplasms / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D009463:Neuroma / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D035583:Rare Diseases; D012983:Soft Tissue Neoplasms / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D013124:Spinal Injuries / Q000150:complications / Q000473:pathology*; D016896:Treatment Outcome
keywords: Case report; Malignant peripheral nerve sheath tumor; Traumatic neuroma