Cellular neurothekeoma of the upper lip in an infant

Atypical cellular neurothekeoma of the oral mucosa: A rare case report and literature review

Cellular neurothekeoma (CN) is a benign dermal neoplasm that most often affects the head and neck region and rarely occurs in the oral mucosa. We report a rare case of CN with atypical features on the floor of the mouth and summarize the reported cases of oral CN in English-language literature. A 62-year-old woman presented with a 6-month history of a painless mass on the floor of the mouth. Histopathological analysis of the excised specimen revealed a proliferation of neoplastic cells with oval to spindle morphology arranged in a vaguely nested and multinodular architecture separated by scarce hyaline collagen within a predominantly myxoid-rich stroma. The tumor cells were positive for NSE, and CD63 (NKI/C3), and negative for S100 protein, CD34, and SMA. Thus, the final diagnosis was CN. In addition, we summarized all clinicopathological data on oral CNs reported in the English-language literature. Nineteen cases were reviewed. Among them, only one case affected the floor of the mouth of a young girl, in contrast to the present case that occurred in an elderly woman. CN is particularly rare in this location and may be a diagnostic challenge for oral pathologists due to its rarity and morphological similarity with other lesions.

Multiple Desmoplastic Cellular Neurothekeomas in Child: Report of the First Oral Case and Review of the Literature

Cellular neurothekeomas (CNs) are distinctive benign tumors of uncertain histogenesis, with predilection for the skin of the head and neck region. We describe the first case of multiple desmoplastic CNs (DCNs) affecting the oral cavity in a 9-year-old girl. Histopathologic evaluation showed a proliferation of spindle and epithelioid cells, forming nests and bundles, supported by exuberant fibrous stroma, as well as scattered multinucleated floret-like giant cells. The tumor cells were immunopositive for vimentin, CD63, CD56, whereas AE1/AE3, S100, CD34, α-SMA, GFAP, EMA, CD57 and NSE were negative. Ki-67 was <2%. Multiple DCNs should be considered in the differential diagnosis of oral nodular lesions.

A Case of a Cellular Neurothekeoma Presenting with Headaches and Review of the Literature

A 12-year-old female presented with a 1-year history of a slow-growing lesion on the frontal scalp. The patient reported intermittent headaches increasing in frequency localized under the lesion. Physical exam revealed a firm, fixed, 5-mm orange-pink papule on the right frontal scalp. Excisional biopsy was performed using a 6-mm punch biopsy, after which the patient reported a cessation of headaches. Histopathology showed a diffuse proliferation of spindled and epithelioid cells within the superficial and deep reticular dermis demonstrating a nested as well as fascicular growth pattern. There was also focal myxoid dermal change. Immunohistochemical staining showed the tumor to be strongly positive for NK1C3 and negative for S-100. A diagnosis of cellular neurothekeoma was made. Cellular neurothekeomas are slow-growing, asymptomatic nodules that most frequently appear on the head and neck of young adults. Cellular neurothekeomas rarely present with symptoms beyond mild tenderness upon palpation. Our case represents a unique presentation of a neurothekeoma of the scalp with complaint of headaches, previously unpublished in the literature.