Yang CM, Li JM, Wang R, Lu LG. Malignant peripheral nerve sheath tumor in an elderly patient with superficial spreading melanoma: A case report. World J Clin Cases 2021; 9(22): 6457-6463 [PMID: 34435012 DOI: 10.12998/wjcc.v9.i22.6457]
Corresponding Author of This Article
Li-Gong Lu, BMed, MD, PhD, Professor, Zhuhai Interventional Medical Center, Zhuhai Precision Medical Center, Zhuhai People's Hospital of Jinan University, No. 79 Kangning Road, Zhuhai 519000, Guangdong Province, China. luligong1969@126.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 6, 2021; 9(22): 6457-6463 Published online Aug 6, 2021. doi: 10.12998/wjcc.v9.i22.6457
Malignant peripheral nerve sheath tumor in an elderly patient with superficial spreading melanoma: A case report
Chong-Miao Yang, Jia-Min Li, Rui Wang, Li-Gong Lu
Chong-Miao Yang, Jia-Min Li, Department of Medical Imaging, Zhuhai Hospital Affiliated with Jinan University, Zhuhai People’s Hospital, Zhuhai 519000, Guangdong Province, China
Chong-Miao Yang, Jia-Min Li, Zhuhai Hospital Affiliated with Jinan University, Jinan University, Guangzhou 510000, Guangdong Province, China
Rui Wang, Department of Pathology, Zhuhai Hospital Affiliated with Jinan University, Zhuhai People’s Hospital, Zhuhai 519000, Guangdong Province, China
Li-Gong Lu, Zhuhai Interventional Medical Center, Zhuhai Precision Medical Center, Zhuhai People’s Hospital of Jinan University, Zhuhai 519000, Guangdong Province, China
Author contributions: Yang CM and Li JM were the patient’s radiologists, reviewed the literature and contributed to manuscript drafting; Li JM reviewed the case and followed up with the patient; Wang R was the patient’s pathologist; Lu LG was responsible for revision of the manuscript and approval of the manuscript; all authors issued final approval for the submission of this article.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Gong Lu, BMed, MD, PhD, Professor, Zhuhai Interventional Medical Center, Zhuhai Precision Medical Center, Zhuhai People's Hospital of Jinan University, No. 79 Kangning Road, Zhuhai 519000, Guangdong Province, China. luligong1969@126.com
Received: March 29, 2021 Peer-review started: March 29, 2021 First decision: April 28, 2021 Revised: May 6, 2021 Accepted: May 26, 2021 Article in press: May 26, 2021 Published online: August 6, 2021
Abstract
BACKGROUND
Malignant peripheral nerve sheath tumor (MPNST) is a type of spindle cell sarcoma originating from the peripheral nerve, which usually results in the corresponding nerve sign on magnetic resonance imaging (MRI). Patients with MPNST may also have neurofibromatosis type 1.
CASE SUMMARY
A 78-year-old male was admitted to the hospital due to a tumor in his left knee. He had a previous history of superficial spreading melanoma on the left thigh. Color Doppler ultrasonography showed a hypoechoic mass in the subcutaneous soft tissues of the medial left knee with an abundant rich blood flow. Computed tomography scanning did not show obvious signs of bone destruction, but the skin adjacent to the tumor was slightly thickened. MRI examination revealed that the hypervascular lesion was well-circumscribed, lobulated, invaded the surrounding soft tissues and demonstrated heterogeneous enhancement but lacked an entering and exiting nerve sign. The MRI result indicated the invasiveness of the tumor. The patient underwent a left knee joint mass expanded resection and the first histopathological examination showed a MPNST with positive surgical margins. Therefore, the second extended resection was performed, and the patient had a good outcome in the short term.
CONCLUSION
MRI is a useful technique for revealing the biological characteristics of MPNST and provides clinical support for evaluation of the surgical area before operation.
Core Tip: Malignant peripheral nerve sheath tumor is a rare peripheral nerve sarcoma originating from the peripheral nerve. We report the first patient with a malignant peripheral nerve sheath tumor and a clinical history of superficial spreading melanoma. Various imaging examinations showed no signs of nerve origin, but magnetic resonance imaging examination showed invasion of surrounding soft tissues, suggesting the aggressiveness of the tumor. An extended resection was performed. The patient received adjuvant radiotherapy following histopathological confirmation of malignant peripheral nerve sheath tumor. Magnetic resonance imaging provided clinical support for evaluation of the surgical area before the operation.
