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The most important diagnosis to rule out in this case is that of a malignant peripheral nerve sheath tumor (MPNST), which would render a dire prognosis for the patient, given its propensity to locally recur and distantly metastasize.
Analgesia of the amputated stump is obtained by nerve sheath block of the sciatic nerve in above-knee amputation and posterior tibial nerve despite the fact that sensory innervations of the anterior aspect of the thigh comes from the femoral nerve.
Immunoprofiles of Similar Spindle Cell Neoplasms Tumor Type Myogenin Desmin SMA SC-RMS ++ ++ +/- Leiomyosarcoma - +/- ++ Low-grade myofibroblastic - +/- + sarcoma Fibrosarcoma - - +/- Malignant peripheral - - - nerve sheath tumor with rhabdomyoblastic differentiation Desmoplastic melanoma - - +/-- Tumor Type H-caldesmon S100 GFAP SC-RMS - - - Leiomyosarcoma +/- - +/-- Low-grade myofibroblastic - - - sarcoma Fibrosarcoma - - +/- Malignant peripheral - +/- - nerve sheath tumor with rhabdomyoblastic differentiation Desmoplastic melanoma - ++ +/- Abbreviations: GFAP, glial fibrillary acidic protein; SC-RMS, spindle cell rhabdomyosarcoma; SMA, smooth muscle actin; +, positive; ++, strongly positive; +/-, occasionally positive; +/--, occasionally positive, more often negative; -, negative.
Malignant peripheral nerve sheath tumor enhances brightly on postcontrast images and often has a central dark area secondary to necrosis and hemorrhage (Figures 3 and 4).
Malignant peripheral nerve sheath tumors (MPNST) are a group of neurogenic tumors that may be sporadic or coexist with neurofibromatosis.
3%) and optic nerve sheath invasion seen in three cases (7.
Usefulness of cytokeratin subsets for distinguishing monophasic synovial sarcoma from malignant peripheral nerve sheath tumor.
In particular, the much more common NF1 comes with an increased risk of systemic findings such as malignant peripheral nerve sheath tumors, optic gliomas, other gliomas, and leukemia.
Schwannomas are benign tumors of peripheral nerve sheath origin, composed of proliferation of Schwann cells in a characteristic pattern.
FISH) but negative for MDM2 by IHC, whereas pleomorphic rhabdomyosarcoma, malignant peripheral nerve sheath tumor, and myxofibrosarcoma may be positive for MDM2 by IHC but negative for MpM2 by FISH.