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Kletskaya I, Belousova I, Makarova O, Narbutov A, Oganesyan R, Donati M, Říčař J, Salgado CM, Reyes-Múgica M, Kazakov DV. Schwannian and Perineuriomatous Differentiation in a Series of Giant Congenital Melanocytic Nevi. Am J Dermatopathol 2024:00000372-990000000-00364. [PMID: 38842402 DOI: 10.1097/dad.0000000000002754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
ABSTRACT Close relationship between melanocytes and neural cells is accepted to reflect their common derivation from the neural crest and tumors combining both elements. We present a series of 10 patients with giant congenital melanocytic nevi (CMN) in which a secondary proliferation (11 lesions) with schwannian and/or perineuriomatous differentiation developed in the course of the disease. The age of the patients (4 male and 6 female) at the time of surgery and histological assessment varied from 3 months to 57 years. Histopathologically, the following subgroups were delineated: (1) nodular/tumoriform "neurotization" in CMN, (2) diffuse neurofibroma-like proliferation within CMN, (3) plexiform neurofibroma-like proliferation within CMN, and (4) diffuse perineuriomatous (hybrid schwannomatous-perineuriomatous) differentiation in CMN. We review the pertinent literature, including the role of recently identified Schwann cell precursors which are believed to represent the nerve-associated state of neural crest-like cells that persists into later developmental stages.
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Affiliation(s)
- Irina Kletskaya
- Russian Children's Clinical Hospital of Pirogov's Russian National Research Medical University of the Ministry of Healthcare, Russian Federation, Moscow, Russia
- Dmitry Rogachev's National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Irena Belousova
- Department of Dermatology, Medical Military Academy, Saint Petersburg, Russia
| | - Olga Makarova
- Russian Children's Clinical Hospital of Pirogov's Russian National Research Medical University of the Ministry of Healthcare, Russian Federation, Moscow, Russia
| | - Anton Narbutov
- Russian Children's Clinical Hospital of Pirogov's Russian National Research Medical University of the Ministry of Healthcare, Russian Federation, Moscow, Russia
| | - Raisa Oganesyan
- Dmitry Rogachev's National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Michele Donati
- Department of Pathology, University Hospital Campus Bio-Medico, Rome, Italy
| | - Jan Říčař
- Department of Dermatology, Charles University Medical Faculty Hospital, Pilsen, Czech Republic
| | - Claudia M Salgado
- Division of Pathology, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh; and
| | - Miguel Reyes-Múgica
- Division of Pathology, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh; and
| | - Dmitry V Kazakov
- IDP Institut für Dermatohistopathologie, Pathologie Institut Enge, Zürich, Switzerland
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Bonomo G, Gans A, Mazzapicchi E, Rubiu E, Alimonti P, Eoli M, Paterra R, Pollo B, Iess G, Restelli F, Falco J, Acerbi F, Schiariti MP, Ferroli P, Broggi M. Sporadic spinal psammomatous malignant melanotic nerve sheath tumor: A case report and literature review. Front Oncol 2023; 13:1100532. [PMID: 36910634 PMCID: PMC9998981 DOI: 10.3389/fonc.2023.1100532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/06/2023] [Indexed: 03/14/2023] Open
Abstract
Background Sporadic Spinal Psammomatous Malignant Melanotic Nerve Sheath Tumor (SSP-MMNST) is a rare subgroup of peripheral nerve sheath tumors arising along the spine. Only a few reports of SSP-MMNST have been described. In this paper, we review the literature on SSP-MMNST focusing on clinical, and diagnostic features, as well as investigating possible pathogenetic mechanisms to better implement therapeutic strategies. We also report an illustrative case of a young female presenting with cervicobrachial pain due to two SSP-MMNSTs arising from C5-6 right spinal roots. Case description We report a case of a 28-year-old woman presenting with right arm weakness and dysesthesia. Clinical examination and neuroimaging were performed, and, following surgical removal of both lesions, a histological diagnosis of SSP-MMNST was obtained. Results The literature review identified 21 eligible studies assessing 23 patients with SSP-MMNST, with a mean onset age of 41 years and a slight male gender preference. The lumbar district was the most involved spinal segment. Gross-total resection (GTR) was the treatment of choice in all amenable cases, followed in selected cases with residual tumor by adjuvant radiotherapy or chemotherapy. The metastatic and recurrence rates were 31.58% and 36.8%, respectively. Conclusion Differently from common schwannomas, MMNST represents a rare disease with known recurrence and metastatization propensity. As reported in our review, SSP-MMNST has a greater recurrence rate when compared to other forms of spinal MMNST, raising questions about the greater aggressiveness of the former. We also found that residual disease is related to a higher risk of systemic disease spreading. This metastatic potential, usually associated with primary lumbar localization, is characterized by a slight male prevalence. Indeed, whenever GTR is unachievable, considering the higher recurrence rate, adjuvant radiation therapy should be taken into consideration.
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Affiliation(s)
- Giulio Bonomo
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy.,School of Medicine, University of Milan, Milan, Italy.,Department of Neurological Surgery, Policlinico "G. Rodolico-S. Marco" University Hospital, Catania, Italy
| | - Alessandro Gans
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy.,School of Medicine, University of Milan, Milan, Italy
| | - Elio Mazzapicchi
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy.,School of Medicine, University of Milan, Milan, Italy
| | - Emanuele Rubiu
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy.,School of Medicine, University of Milan, Milan, Italy
| | - Paolo Alimonti
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Marica Eoli
- Molecular Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Rosina Paterra
- Molecular Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Bianca Pollo
- Neuropathology Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Guglielmo Iess
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy.,School of Medicine, University of Milan, Milan, Italy
| | - Francesco Restelli
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy.,School of Medicine, University of Milan, Milan, Italy
| | - Jacopo Falco
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy.,School of Medicine, University of Milan, Milan, Italy
| | - Francesco Acerbi
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Marco Paolo Schiariti
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Paolo Ferroli
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Morgan Broggi
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
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Plexiform Melanocytic Schwannoma: Report of a Second Case and Overview of a Rare Entity. Am J Dermatopathol 2022; 44:943-947. [DOI: 10.1097/dad.0000000000002311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Nguyen QBD, Lauck KC, Hebert AA, Greives MR. Cutaneous Melanotic Schwannoma in a Pediatric Patient. Dermatol Surg 2021; 47:1661-1663. [PMID: 34743119 DOI: 10.1097/dss.0000000000003267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Quoc-Bao D Nguyen
- Department of Dermatology, UTHealth McGovern Medical School, Houston, Texas
- Department of Dermatology, MD Anderson Cancer Center, Houston, Texas
| | - Kyle C Lauck
- UTHealth McGovern Medical School, Houston, Texas
| | - Adelaide A Hebert
- Department of Dermatology, UTHealth McGovern Medical School, Houston, Texas
- Department of Dermatology, MD Anderson Cancer Center, Houston, Texas
| | - Matthew R Greives
- Division of Pediatric Plastic Surgery, Department of Pediatric Surgery, UTHealth McGovern Medical School
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Shen XZ, Wang W, Luo ZY. 18F-FDG PET/CT imaging for aggressive melanotic schwannoma of the L3 spinal root: A case report. Medicine (Baltimore) 2021; 100:e24803. [PMID: 33663098 PMCID: PMC7909145 DOI: 10.1097/md.0000000000024803] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/21/2021] [Accepted: 01/29/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Melanotic schwannoma (MS) is an unusual variant of a nerve sheath neoplasm that accounts for less than 1% of all primary peripheral nerve sheath tumors. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) has unique value in detecting malignant MS lesions. To date, only 4 cases of MS with hepatic metastasis have been reported. Herein, we report the fifth case, which is the first reported patient with MS of Asian ethnicity with hepatic metastasis. PATIENT CONCERNS A 29-year-old woman with a 1-day history of backache was admitted to our hospital. PET/CT showed a paravertebral heterogeneous soft tissue mass along the spinal nerve at the L2-L3 level with strong FDG uptake, and a nodule with increased FDG uptake in the lateral lobe of the left liver. DIAGNOSIS A puncture biopsy of the L3 bony destruction and surrounding soft tissue mass was performed. The final diagnosis was spinal MS with hepatic metastasis. INTERVENTIONS The patient underwent 6 courses of systemic chemotherapy. OUTCOMES The patient did not receive further treatment for half a year after the end of chemotherapy and recovered well. LESSONS Unlike conventional schwannomas, which are completely benign, MS has an unpredictable prognosis. It is thought to have low malignant potential, and the malignant type tends to metastasize. FDG PET/CT has a unique and important value in the differential diagnosis of benign and malignant lesions, in detecting occult metastases, monitoring the treatment response, and assessing the prognosis of MS.
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Affiliation(s)
- Xun-Ze Shen
- PET/CT Center, Shaoxing People's Hospital, the First Affiliated Hospital of Shaoxing University, 568 Zhongxing North Rd, Shaoxing City
| | - Wei Wang
- Wei Wang, Department of Pathology, Zhejiang Provincial People's hospital, Hangzhou City, Zhejiang Province, China
| | - Zhou-Ye Luo
- PET/CT Center, Shaoxing People's Hospital, the First Affiliated Hospital of Shaoxing University, 568 Zhongxing North Rd, Shaoxing City
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Swift CC, Hackett NJ, Chandler JP, McComb EN. Nevus of Ota with midface tumors and a vanishing orbital mass. Clin Imaging 2020; 71:117-120. [PMID: 33190058 DOI: 10.1016/j.clinimag.2020.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/04/2020] [Accepted: 10/07/2020] [Indexed: 10/23/2022]
Abstract
Nevus of Ota, also known as oculodermal melanocytosis, is a benign melanocytic lesion that develops along the distribution of the V1 and V2 branches of the trigeminal nerve. Prior reports have described the typical imaging and clinical features of nevus of Ota. We present a rare case of a 31 year-old female with midface tumors and presumed hemorrhage into an orbital lesion in the setting of nevus of Ota resulting in acute loss of vision.
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Affiliation(s)
- Caroline C Swift
- Division of Neuroradiology, Northwestern University, Feinberg School of Medicine, United States of America
| | - Nicholas J Hackett
- Division of Ophthalmology, Northwestern University, Feinberg School of Medicine, United States of America
| | - James P Chandler
- Division of Neurosurgery, Northwestern University, Feinberg School of Medicine, United States of America
| | - Erin N McComb
- Division of Neuroradiology, Northwestern University, Feinberg School of Medicine, United States of America.
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Agarwalla PK, Koch MJ, Mordes DA, Codd PJ, Coumans JV. Pigmented Lesions of the Nervous System and the Neural Crest: Lessons From Embryology. Neurosurgery 2016; 78:142-55. [PMID: 26355366 DOI: 10.1227/neu.0000000000001010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Neurosurgeons encounter a number of pigmented tumors of the central nervous system in a variety of locations, including primary central nervous system melanoma, blue nevus of the spinal cord, and melanotic schwannoma. When examined through the lens of embryology, pigmented lesions share a unifying connection: They occur in structures that are neural crest cell derivatives. Here, we review the important progress made in the embryology of neural crest cells, present 3 cases of pigmented tumors of the nervous system, and discuss these clinical entities in the context of the development of melanoblasts. Pigmented lesions of the nervous system arise along neural crest cell migration routes and from neural crest-derived precursors. Awareness of the evolutionary clues of vertebrate pigmentation by the neurosurgical and neuro-oncological community at large is valuable for identifying pathogenic or therapeutic targets and for designing future research on nervous system pigmented lesions. When encountering such a lesion, clinicians should be aware of the embryological basis to direct additional evaluation, including genetic testing, and to work with the scientific community in better understanding these lesions and their relationship to neural crest developmental biology.
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Affiliation(s)
- Pankaj K Agarwalla
- Departments of *Neurosurgery and‡Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Adameyko I, Fried K. The Nervous System Orchestrates and Integrates Craniofacial Development: A Review. Front Physiol 2016; 7:49. [PMID: 26924989 PMCID: PMC4759458 DOI: 10.3389/fphys.2016.00049] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 02/02/2016] [Indexed: 01/14/2023] Open
Abstract
Development of a head is a dazzlingly complex process: a number of distinct cellular sources including cranial ecto- and endoderm, mesoderm and neural crest contribute to facial and other structures. In the head, an extremely fine-tuned developmental coordination of CNS, peripheral neural components, sensory organs and a musculo-skeletal apparatus occurs, which provides protection and functional integration. The face can to a large extent be considered as an assembly of sensory systems encased and functionally fused with appendages represented by jaws. Here we review how the developing brain, neurogenic placodes and peripheral nerves influence the morphogenesis of surrounding tissues as a part of various general integrative processes in the head. The mechanisms of this impact, as we understand it now, span from the targeted release of the morphogens necessary for shaping to providing a niche for cellular sources required in later development. In this review we also discuss the most recent findings and ideas related to how peripheral nerves and nerve-associated cells contribute to craniofacial development, including teeth, during the post- neural crest period and potentially in regeneration.
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Affiliation(s)
- Igor Adameyko
- Department of Physiology and Pharmacology, Karolinska InstitutetStockholm, Sweden; Department of Molecular Neurosciences, Center of Brain Research, Medical University of ViennaVienna, Austria
| | - Kaj Fried
- Department of Neuroscience, Karolinska Institutet Stockholm, Sweden
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Luzar B, Tanaka M, Schneider J, Calonje E. Cutaneous microcystic/reticular schwannoma: a poorly recognized entity. J Cutan Pathol 2015; 43:93-100. [PMID: 26350054 DOI: 10.1111/cup.12624] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 07/19/2015] [Accepted: 08/02/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Microcystic/ reticular schwannoma is exceptionally rare yet distinctive morphological variant of schwannoma with predilection for visceral sites lacking association with neurofibromatosis. AIMS To further delineate clinicopathological features of cutaneous microcystic/reticular schwannoma and to discuss its differential diagnosis. RESULTS We analyzed three cutaneous microcystic/reticular schwannomas, occurring in two males and one female (mean age: 37.6 years). The tumors presented as a non-painful slightly raised papule (mean: 0.7 cm) on upper arm (n = 2) and back (n = 1). No recurrences were observed despite marginal excision (mean follow up: 42 months). Histopathologically, a multilobular proliferation was present in the dermis composed of bland tumor cells forming distinctive microcystic, reticular, lace-like or pseudoglandular structures, containing abundant myxoid/mucinous material. By immunohistochemistry, tumor cells lining microcystic structures corresponded to Schwann cells (diffuse S100 positive, variable GFAP positivity). A discontinuous EMA-positive perineurium was present at the periphery of some of the lobules. CONCLUSION Cutaneous microcystic/reticular schwannoma expands the spectrum of benign peripheral nerve sheath tumors with reticular morphology encountered in the skin. Other tumors in this group include reticular perineurioma and hybrid tumors with reticular morphology, e.g. reticular perineurioma/schwannoma and reticular perineurioma/neurofibroma.
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Affiliation(s)
- Boštjan Luzar
- Institute of Pathology, Medical Faculty University of Ljubljana, Ljubljana, Slovenia
| | - Maiko Tanaka
- Department of Dermatology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Johann Schneider
- Division of Anatomical Pathology at University of Stellenbosch, Cape Town, South Africa
| | - Eduardo Calonje
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
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