A Case of Scalp Neurothekeoma

ABSTRACT

Neurothekeoma is a relatively uncommon tumor of nerve sheath origin. Most of these tumors are benign and malignant transformation was not reported. Usually, these tumors arise during childhood or early adulthood life with female preponderance. They have a predilection for the head, neck and shoulder region but any part of the body may be affected. Their usual size is between 0.5-3.0 cm. Rapid growth and ulceration are rare, and local recurrence tends to occur after incomplete excision. We report a case of neurothekeoma developed in the scalp of a 21-year-old woman. It was first noticed about 1year ago. This mass had been increasing in size slowly. On physical examination, 2 x 1.5 cm sized papule with localized alopecia was identified on the frontal scalp area. It was excised in 5.5 x 3.6 cm. The histologic finding of the lesion showed that lobules, fascicles or rests of spindle shaped or epitheloid cells in a myxoid of mucosubstance. The tumor cells were positive for S-100 and vimentin but showed negative for EMA, cytokeratin, desmin, actin and HMB45. After surgical excision of tumor, split-thickness skin graft was done. Three months after the operation, rectangular shape tissue expander (180 cc Sebbin(R)) was inserted on both sides of the previous wound. After removal of tissue expander, the wound closed with local flap. The patient did not have any evidence of recurrence for 6 months.