Cellular Neurothekeoma – Rare but exists

Patient 2 -Figure 6) Tumor of 4x4 cm on the scalp.Figure 7) Pleomorphic cells and nuclear atypia (H&E).Figure 8) Ulcerated area (H&E).Figure 9) Neoplastic embolus in a vessel of medium caliber (H&E).Figure 10) Neoplastic embolus in a vessel of medium caliber (desmin).Results: Patient 1 is on follow up for 2 years and patient 2 for 4 years, and no signs of recurrence or metastasis were observed.Conclusions: PDS and AF share a clinicopathological spectrum, histologically presenting as spindle and pleomorphic cells randomly distributed.The differentiation between these two entities is not possible through superficial biopsies and the final diagnosis should preferably be made after complete tumoral excision.Tumor necrosis, infiltration of subcutaneous tissue, and lymphovascular or perineural invasion are present only in PDS.While AF generally presents a good prognosis, PDS courses with a 20-30% risk for local recurrence and metastasis to the skin, lymph nodes, or lungs.PDS tumor cells are negative for S100 protein, cytokeratins, HMB45 antigen, CD34, and desmin.CD10 staining is positive and diffuse, and there is an expression of SMA in 70% of the cases and of CD31 in 30% of the cases.Other differential diagnoses include melanoma, poorly differentiated carcinoma, and leiomyosarcoma.The treatment of choice is complete surgical excision and radiation therapy may be considered if adequate surgical margins cannot be obtained.