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A Case of Neck Metastasis of Malignant Peripheral Nerve Sheath
Tumor (MPNST) |
Dept. of Otolaryngology©ö, Dept. of Pathology©÷, Univ. of Ulsan College of Medicine, Asan Medical Center |
Hyun MOON,
Hyun MOON1, Ji Won KIM1, Kyoung-Ja CHO2, Yoon Se LEE1, Jong-Lyel ROH1, Seung-Ho CHOI1, Sang Yoon KIM1, Soon Yuhl NAM1
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MPNST is a form of cancer of the connective tissue surrounding
nerves. The case of MPNST in forms of lymph node (LN) metastasis
was not reported yet. Here, we report a case of MPNST in LN
presenting as a neck mass.
A11-year-old man visited out-patient clinic due to right neck
mass. Contrast enhanced CT scan of neck revealed a 3 cm sized
soft tissue mass in the right side neck level 2 superficial area.
Histopathology from sono-guided needle biopsy revealed a benign
spindle cell neoplasm. He underwent surgical excision of neck
mass. Under general anesthesia, we identified subcutaneous mass
distinguishable from parotid gland. Pathologically, a cellular
tumor composed of spindle nerve sheath inLN. Immunohistochemical
staining showed positive finding for vimentin, S-100, neuron
specific enolase, negative for neurofilament, TLE-1, and HMB45.
And final pathology was confirmed as neck metastasis of MPNST. To
find the primary lesion, whole body PET/CT and MR were performed,
but primary lesion was not detected. On PET and MR, metastatic LN
was detected at right level I area. Secondary surgical excision
was done and followed by chemotherapy and radiotherapy. |
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