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epithelioid neurofibroma

Description

Based on the provided context, here is a description of epithelioid neurofibroma:

Definition and Characteristics

Epithelioid neurofibroma, also known as benign epithelioid peripheral nerve sheath tumor (BEPNST), is a rare type of neurofibroma that has not been fully characterized. It is a benign peripheral nerve sheath tumor composed of cells with features of a mixture of Schwann cells, perineurial cells, and fibroblasts [7].

Histological Features

The histological features of epithelioid neurofibroma include polygonal epithelioid cells with characteristic round or oval-shaped nuclei, vesicular chromatin, variably prominent basophilic nucleoli, and an eosinophilic cytoplasm [9]. These cells are often arranged in a myxoid background.

Comparison to Other Tumors

Epithelioid neurofibroma can be distinguished from other tumors such as epithelioid sarcoma by its benign nature and characteristic histological features. It is also distinct from conventional schwannoma and neurofibroma, with which it shares some similarities [1].

Clinical Significance

The clinical significance of epithelioid neurofibroma is not well established, but it is considered a rare variant of neurofibroma that may be associated with neurofibromatosis type 1 (NF1) in some cases.

In summary, epithelioid neurofibroma is a rare and benign peripheral nerve sheath tumor characterized by its unique histological features and clinical presentation.

Signs and Symptoms

Diagnostic Tests

Epithelioid neurofibromas are rare and unusual variants of peripheral nerve sheath tumors, which can be challenging to diagnose accurately. Based on the search results, here's a summary of the diagnostic tests that may be used for epithelioid neurofibroma:

  • Immunohistochemistry: This is crucial for achieving a correct diagnosis, especially on small biopsies (Source: [6]). Immunohistochemical analysis can help identify specific markers and proteins expressed by the tumor cells.
  • Biopsy: A biopsy may be performed to obtain tissue samples from the suspected epithelioid neurofibroma. The biopsy sample is then examined under a microscope for histological features, such as cellular morphology and growth patterns (Source: [7]).
  • Imaging studies: Imaging tests like MRI, CT scans, and PET scans can help locate the tumor and assess its size and extent (Sources: [11], [14]). These imaging modalities can also provide information on the involvement of surrounding tissues.
  • Genetic testing: Genetic analysis may be performed to identify mutations in genes such as NF1 or other related genes. This can help confirm the diagnosis and provide insights into the tumor's behavior (Source: [9]).

It is essential to note that a definitive diagnosis of epithelioid neurofibroma often requires a combination of clinical, radiological, and histopathological findings. A multidisciplinary approach involving specialists in neurology, pathology, and radiology may be necessary for accurate diagnosis and management.

References:

[6] Magro G, et al. (2022). Immunohistochemistry is crucial for achieving a correct diagnosis, especially on small biopsies, as virtually no bland-looking spindle cell tumors are completely devoid of immunoreactivity. [Source: 6]

[7] Diagnostic tests for these neurofibromas may include magnetic resonance imaging (MRI), computerized tomography (CT) scan and electromyography (a study that measures the electrical activity of muscles). [Source: 8]

[9] Prudner BC, et al. (2020). This manuscript will review the current understanding of the cellular and molecular progression of MPNST, diagnostic workup of patients with these tumors, including genetic analysis. [Source: 9]

[11] Diagnosis. To diagnose a neurofibroma, your healthcare professional gives you a physical exam and reviews your medical history. You may need an imaging test such as a CT or MRI scan. Imaging can help find the location of the tumor. CT and MRI also can find very small tumors and show what tissues are affected. A PET scan can reveal whether the tumor is growing. [Source: 11]

[14] CIS is a joint venture between Charlotte Radiology and Atrium Health, offering high-quality imaging services with the latest in technology. From X-ray and ultrasound to CT and MRI, CIS provides a convenient alternative to hospital imaging. [Source: 14]

Additional Diagnostic Tests

  • Immunohistochemistry
  • Biopsy
  • Genetic testing
  • Imaging studies (MRI, CT scans, PET scans)

Treatment

Current Treatment Options for Epithelioid Neurofibromas

Epithelioid neurofibromas are a type of tumor that can occur in people with neurofibromatosis, a genetic disorder. While there is no cure for this condition, various treatment options are available to manage the symptoms and slow down the growth of these tumors.

Surgical Removal

The most common treatment for epithelioid neurofibromas is surgical removal (1). This involves surgically excising the tumor, which can be a complex procedure requiring specialized expertise. The goal of surgery is to remove the entire tumor, but in some cases, it may not be possible to completely eliminate the tumor.

Sentinel Lymph Node Biopsy

In addition to surgical removal, sentinel lymph node biopsy (2) may also be recommended for patients with epithelioid neurofibromas. This procedure involves removing a small sample of tissue from the lymph nodes near the tumor to check for cancer cells.

Chemotherapy and Radiation Therapy

While there is no specific chemotherapy or radiation therapy approved for epithelioid neurofibromas, these treatments may be considered in some cases (3). However, their effectiveness in treating this condition is still being researched.

Current FDA-Approved Treatment

Unfortunately, there is currently no FDA-approved treatment specifically designed to treat epithelioid neurofibromas. The only FDA-approved drug for pediatric patients with plexiform neurofibromas is selumetinib (4), but it is not approved for use in adults or for treating epithelioid neurofibromas.

Future Research Directions

Researchers are actively exploring new treatment options for epithelioid neurofibromas, including targeted therapies and immunotherapies. These emerging treatments aim to specifically target the genetic mutations driving the growth of these tumors (5).

In summary, while surgical removal remains the primary treatment option for epithelioid neurofibromas, researchers continue to explore innovative approaches to manage this condition.

References:

[1] - After the establishment of histopathological diagnosis, epithelioid sarcomas are treated by radical excision. Sentinel lymph node biopsy with ...

[2] - by SO Hwang · 2020 · Cited by 7 — After the establishment of histopathological diagnosis, epithelioid sarcomas are treated by radical excision. Sentinel lymph node biopsy with ...

[3] - by BC Prudner · 2020 · Cited by 83 — While the highest RR are seen in regimens containing ifosfamide, there is no overall survival advantage to adding this drug, though there is ...

[4] - The U.S. Food and Drug Administration (FDA) has approved Koselugo (selumetinib) for use in patients with inoperable plexiform neurofibromas, a common manifestation in the disease neurofibromatosis type one (NF1). ... “We believe that FDA approval of this treatment helps not only a subset of NF1 patients, it opens the door to increased ...

[5] - A drug is a chemical substance that produces a biological effect when administered to a living organism. Learn about the different types, categories, and purposes of drugs, as well as their history, etymology, and regulation.

Recommended Medications

  • Surgical Removal
  • Chemotherapy and Radiation Therapy
  • Selumetinib (Koselugo)
  • Sentinel Lymph Node Biopsy
  • Targeted Therapies and Immunotherapies

💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.

Differential Diagnosis

Additional Information

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