Neurothekeoma

Neurothekeoma is a rare, benign tumor of the skin that is believed to originate from nerve sheath cells. It was first described in the medical literature by Harkin and Reed in 1969. Neurothekeomas are most commonly found on the head, neck, and upper extremities, but can occur anywhere on the body. They are most often seen in young adults, with a slight predominance in females.

Clinical Presentation

Patients with neurothekeoma typically present with a solitary, slow-growing, painless nodule. The size of the nodule can range from a few millimeters to several centimeters in diameter. The overlying skin is usually normal in appearance, but may be slightly discolored.

Histology

Under the microscope, neurothekeomas are characterized by nests of spindle-shaped cells in the dermis. These cells are often arranged in a pattern that resembles a mosaic. The cells are typically positive for S-100 protein, a marker of nerve sheath cells.

Diagnosis

The diagnosis of neurothekeoma is made based on the clinical presentation and histopathology. Other conditions that can mimic neurothekeoma include dermatofibroma, neurofibroma, and spitz nevus. Therefore, a biopsy is often necessary to confirm the diagnosis.

Treatment

The treatment of choice for neurothekeoma is surgical excision. Because neurothekeomas are benign, they do not spread to other parts of the body. However, they can recur if not completely removed.

Prognosis

The prognosis for patients with neurothekeoma is excellent. After complete surgical removal, the recurrence rate is low. There are no known cases of neurothekeoma transforming into a malignant tumor.