Atypical Cellular Neurothekeoma Treated with Mohs Micrographic Surgery

Benbenisty, Keith M.; Andea, Aleodor A.; Metcalf, John S.; Cook, J.

doi:10.1097/00042728-200604000-00021

Cited by 4 publications

(6 citation statements)

References 16 publications

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“…The most common sites of involvement on the head were the nose and scalp 1 . Recent reports have documented CNT of the nasal ala, 4–6 nasal tip, 7 lower lip, 8 left cheek, 9 occiput, 10 and forearm 11 …”

Section: Discussionmentioning

confidence: 99%

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Mohs Micrographic Surgery for the Treatment of Cellular Neurothekeoma and Review of Its Use in Surgical Management of Benign Tumors

Sage

LoPiccolo

Laungani

et al. 2010

Dermatologic Surgery

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Section: Discussionmentioning

confidence: 99%

“…MMS has been reported in only three previous occurrences of CNT (Table 1). 4,5,7 Krathen and Donnelly treated a case of atypical CNT on the nasal tip of a 19‐year‐old Caucasian woman that required two layers to clear 7 . She was lost to follow‐up after surgery.…”

Section: Discussionmentioning

confidence: 99%

Mohs Micrographic Surgery for the Treatment of Cellular Neurothekeoma and Review of Its Use in Surgical Management of Benign Tumors

Sage

LoPiccolo

Laungani

et al. 2010

Dermatologic Surgery

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“…Several large series of cellular neurothekeoma have been published, but only few cases have been reported in its atypical variant (Table 1). 7,9–11 Thus, the clinical features and morphologic spectrum of this lesion remain incompletely defined and the significance of atypical histologic features has been the subject of only limited study. Busam et al described the morphological parameters to identify this more aggressive variant, raising concern about the malignant potential of this lesion 7 .…”

Section: Discussionmentioning

confidence: 99%

A rare case of atypical cellular neurothekeoma in a 68‐year‐old woman

Mertz¹,

Mentzel

Grob³

et al. 2009

J Cutan Pathol

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Cellular neurothekeoma is a benign dermal lesion of uncertain differentiation. The atypical variant of cellular neurothekeoma, characterized by features such as large size, deep penetration, diffusely infiltrative borders, vascular invasion, high mitotic rate and marked cytologic pleomorphism, has been very rarely reported in the literature. We present the clinical, histopathological and immunohistochemical profile of a new case of atypical cellular neurothekeoma in a 68-year-old female patient who was diagnosed with ductal breast carcinoma in situ before. An erythematous painless papule arose in her right breast, and tentative clinical diagnosis was orientated toward skin metastasis of breast cancer or fibroma. Upon histological examination, the lesion showed the histological and immunohistochemical features of atypical variant of cellular neurothekeoma with high mitotic rate, marked cellular pleomorphism and penetration into subcutaneous fat. A further unusual feature in our patient was her age, because she is the oldest patient reported in the literature with diagnosis of atypical cellular neurothekeoma so far. Prognosis remains uncertain because only few cases of atypical cellular neurothekeoma have been reported in the literature, with a very limited follow-up time. Our report contributes to a better characterization of the clinical and morphologic features of atypical cellular neurothekeoma.

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“…We read with interest articles by Peters and Wentzell 1 and Benbenisty and colleagues 2 regarding Mohs micrographic surgery for cellular neurothekeomas. We, too, recently treated a patient with an atypical cellular neurothekeoma on the nose with Mohs surgery.…”

Section: Letter To the Editormentioning

confidence: 99%

Letter: Mohs Micrographic Surgery for Cellular Neurothekeoma with Atypia

Krathen

Donnelly

2008

Dermatol Surg

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Letter to the Editor:We read with interest articles by Peters and Wentzell 1 and Benbenisty and colleagues 2 regarding Mohs micrographic surgery for cellular neurothekeomas. We, too, recently treated a patient with an atypical cellular neurothekeoma on the nose with Mohs surgery.A 19-year-old female presented to the office referred by dermatology for a red-brown papule on the left nasal tip that had been slowly growing over many months. Biopsy showed a cellular neurothekeoma with atypia and complete excision was recommended. Owing to the location and the tendency for recurrence, Mohs micrographic surgery was performed. The tumor was cleared in two stages. The resulting defect was repaired with a superiorly based island pedicle flap receiving its blood supply from a lateral nasalis muscle sling.The utility of Mohs surgery goes well beyond basal and squamous cell carcinomas and, in our opinion, beyond treatment of cutaneous malignancy. Behroozan and coworkers 3 described the application of Mohs surgery for benign skin tumors. Their point is certainly valid. Tissue-sparing surgery with margin control for benign lesions with a tendency for local recurrence is ideal. The basic tenets of Mohs surgery enable such tumor clearance unlike any other method.Third-party payers should be educated to realize the value of Mohs surgery and its place in treating certain benign skin lesions. They should provide coverage for removal of such benign skin tumors with tendency for local recurrence. References1. Peters GE Jr, Wentzell M. Cellular neurothekeoma treated with Mohs micrographic surgery. Dermatol Surg 2007;33:239-44. 2. Benbenisty KM, Andea A, Metcalf J, et al. Atypical cellular neurothekeoma treated with Mohs micrographic surgery. Dermatol Surg 2006;32:582-7. 3. Behroozan DS, Goldberg LH, Glaich AS, et al. Mohs micrographic surgery for deeply penetrating, expanding benign cutaneous neoplasms. Dermatol Surg 2006;32:958-65.

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Atypical Cellular Neurothekeoma Treated with Mohs Micrographic Surgery

Cited by 4 publications

References 16 publications

Mohs Micrographic Surgery for the Treatment of Cellular Neurothekeoma and Review of Its Use in Surgical Management of Benign Tumors

Mohs Micrographic Surgery for the Treatment of Cellular Neurothekeoma and Review of Its Use in Surgical Management of Benign Tumors

A rare case of atypical cellular neurothekeoma in a 68‐year‐old woman

Letter: Mohs Micrographic Surgery for Cellular Neurothekeoma with Atypia

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