An unusual epithelial sheath neuroma in a 74-year-old woman

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.