An unusual epithelial sheath neuroma in a 74-year-old woman
DOI:
https://doi.org/10.5070/sq4g4z85Keywords:
differential diganosisAbstract
Epithelial sheath neuroma is a cutaneous tumor presenting as an erythematous and often painful lesion on the skin of the back. We report a 74-year-old woman with a 7mm epithelial sheath neuroma located on the right upper central back. The initial clinical impression was a basal cell carcinoma and histopathologically, the tumor mimicked a carcinoma with perineural invasion. She had no prior trauma or surgeries at the surgical site. She reported experiencing pain at the site of the tumor. Pain is a symptom of more than half of the reported epithelial sheath neuroma cases. The papule was excised, and there has been no recurrence at the surgical site. We report the unusual occurrence of this very uncommon neoplasm, a tumor that might be inadvertently confused with an aggressive squamous cell carcinoma.
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References
1. Zelger BG, Zelger B. Epithelial sheath neuroma: A benign neoplasm?. Am J Surg Pathol. 2001;25:696-8. [PMID: 11342788].
2. Luzar B, Šekoranja D. An update on cutaneous tumours with neural differentiation. Diagnostic Histopathology. 2022;28:14-37. [DOI: 10.1016/10.004].
3. Lin TY, Zhang AY, Bayer-Garner IB, Krell JM, Acker SM. Epithelial sheath neuroma: A case report and discussion of the literature. Am J Dermatopathol. 2006;28:216-219. [PMID: 16778489].
4. Requena L, Grosshans E, Kutzner H, et al. Epithelial sheath neuroma: a new entity. Am J Surg Pathol. 2000;24:190.
5. Bahmad HF, Gogola S, Rejzer M, et al. Unraveling the mysteries of perineural invasion in benign and malignant conditions. Current Oncology. 2023;30:8948-8972. [PMID: 37887547].
6. Sughrue ME, Levine J, Barbaro NM. Pain as a symptom of peripheral nerve sheath tumors: Clinical significance and future therapeutic directions. J Brachial Plex Peripher Nerve Inj. 2008;3:6. [PMID: 18312658].
7. Shanouda S, Kaya G. Benign cutaneous peripheral nerve sheath tumor with hybrid features: Report of two cases with schwannoma/perineurioma and schwannoma/neurofibroma components. Dermatopathology (Basel). 2017;4:1-6. [PMID: 29456994].
8. Al-Dalahmah O, McEntire C, Niedt GW. Epithelial sheath neuroma: A case report and literature review. Clin Neuropathol. 2020;39:232-237. [PMID: 32383640].
9. Noparstak M, Zaycosky M, Saeed S. Epithelial sheath neuroma with extension to the subcutis. J Cutan Pathol. 2018;45:705-707. [PMID: 29797343].
10. Flora A, Kim RH, Lara Rivero AD, Carr U, Isaacs F. Epithelial sheath neuroma: A case series. JAAD Case Rep. 2020;6:240-242. [PMID: 32140527].
11. Alaaraj R, Nirenberg A. Case report and literature review of epithelial sheath neuroma: Uncommon benign skin tumour. Pathology. 2024;56:S45 [DOI: 10.1016/12.155].
12. Hirano-Ali SA, Bryant EA, Warren SJ. Epithelial sheath neuroma: Evidence supporting a hyperplastic etiology and epidermal origin. J Cutan Pathol. 2016;43:531-534. [PMID: 26990371].
13. McFaddin C, Greene J, Parekh P. Epithelial sheath neuroma mimicking perineural invasion of a dysplastic nevus. Journal of the American Academy of Dermatology. 2013;68:AB85 [DOI:10.1016/12.354].
14. Husain EA, Al-Daraji WI. Epithelial sheath neuroma: Be aware of benign perineural invasion!. J Cutan Pathol. 2009;36:570-572. [PMID: 19476526].
15. Requena L, Grosshans E, Kutzner H, et al. Epithelial sheath neuroma: A new entity. Am J Surg Pathol. 2000;24:190-196. [PMID: 10680886].
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Copyright (c) 2025 Ava Tsapatsaris, Alejandro Gru (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
