Cellular Neurothekeoma vs Nerve Sheath Myxoma - Dermpath Lookalikes

A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).
Confused about "neurothekeoma"? You are not alone. And hopefully you'll feel better after watching this video, which discusses dermal nerve sheath myxoma (formerly called conventional or myxoid neurothekeoma) and cellular neurothekeoma. The two entities are totally unrelated, but because of some overlapping histologic features and a lot of very confusing nomenclature used in older literature, there has been enormous confusion about them that has vexed generations of pathologists. This video is dedicated to my friend and colleague, Dr. Jaime Arturo Mejia, who loves to discuss these entities and to lament the confusion they cause for everyone.
A list of my nerve sheath tumor videos:
- Schwannoma: kikoxp.com/posts/4093
- Malignant peripheral nerve sheath tumor (MPNST) - classic, epithelioid, & Triton: kikoxp.com/posts/4092
- Nerve sheath myxoma vs cellular neurothekeoma: kikoxp.com/posts/4103
- Neurofibroma, Neurofibromatosis-1, and Low Grade MPNST: kikoxp.com/posts/4091
- Palisaded encapsulated neuroma: kikoxp.com/posts/3844
Dermal nerve sheath myxoma:
- Finger/hand usually
- Hypocellular, bland cytology, no/low mitoses
- Recurrence common
- S100 & SOX-10 (+)
- True nerve sheath tumor
Cellular neurothekeoma:
- Face/shoulder/arm (usually not finger/hand)
- Cellular, but may have hypocellular myxoid areas
- May have marked atypia & many mitoses = still benign
- Recurrence uncommon
- S100 & SOX-10 negative
- NOT a nerve sheath tumor (name is misnomer)
Suggested reading:
www.ncbi.nlm.nih.gov/pubmed/1...
www.ncbi.nlm.nih.gov/pubmed/1...
www.ncbi.nlm.nih.gov/pubmed/1...
www.ncbi.nlm.nih.gov/pubmed/2...
Please check out my Soft Tissue Pathology & Dermatopathology survival guide textbooks: bit.ly/2Te2haB ‬
This video is geared towards medical students, pathology or dermatology residents, or practicing pathologists or dermatologists. Of course, this video is for educational purposes only and is not formal medical advice or consultation.
Presented by Jerad M. Gardner, MD. Please subscribe to my channel to be notified of new pathology teaching videos.
Follow me on:
Snapchat: JMGardnerMD
Twitter: @JMGardnerMD
Instagram: @JMGardnerMD
Kiko: kikoxp.com/profile/jerad_gard...
Facebook: / jmgardnermd

[@JMGardnerMD]

A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).

[@ronanknittel4720]

I watched this video a few months ago and got a case a few days ago and immediately knew it was a neurothekeoma thanks to this video! Great teaching.

[@JMGardnerMD]

Dermal nerve sheath myxoma: - Finger/hand usually - Hypocellular, bland cytology, no/low mitoses - Recurrence common - S100 & SOX-10 (+) - True nerve sheath tumor Cellular neurothekeoma: - Face/shoulder/arm (usually not finger/hand) - Cellular, but may have hypocellular myxoid areas - May have marked atypia & many mitoses = still benign - Recurrence uncommon - S100 & SOX-10 negative - NOT a nerve sheath tumor (name is misnomer) See video description above for links for more suggested reading on this topic.

[@divyacheedella7504]

Sir what are the tumors that show S 100 positive

[@nooramk1804]

Excellent talk as always, i always confused with these entities, thank you very much dr.Gerard

[@joshuafox1710]

thank you for this. telling the story of the history of the names made it easier to understand and remember. thanks for “making dermpath great again”

[@that1guy986]

Thank you for all this info Dr. Gardner. I was diagnosed with Cellular Neurothekioma. I’ve had one tumor surgically removed from my hand (thumb, 1-1.5 years ago) and it has since come back (just like you said). I also have a few of these on my head as well now. Since I’m once again facing another surgery i wanted to do some research. Although i may not be an aspiring pathologists, I found this video extremely enlightening . Thank you very much once again.

[@yuyang676]

Terrific cases, thank you, Dr. Gardner.

[@kellybrenanmd3850]

You are literally the best

[@madhudewan8207]

Terrific presentation ❤

[@annak628]

This is so incredibly helpful!!

[@JMGardnerMD]

Check out this myxoid tumor review article by Dr. Nicole Riddle & me (free fulltext): bit.ly/myxoidtumors

[@johnfazio2892]

Another great presentation .

[@laurabattle4354]

Great video! Thanks Dr. Gardner!!!

[@JMGardnerMD]

Glad you like it, Laura!

[@kevinwhitehead6373]

A fantastic demonstration of these two entities. I have seen an atypical cellular neurothekeoma (on partial biopsy) where epithelioid sarcoma needed excluding along with melanocytic lesions.

[@maramjassem8781]

You are the best 🌸

[@sinohui3]

Wow. Thank you for sharing. More of this please.

[@JMGardnerMD]

A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).

[@tinocasadeitherezo6063]

More than the nerve sheath myxoma, the differential with perineurioma is much harder for me to do when considering cellular neurothekeoma. Don't you think so, too? Thank you.

[@znrsmsaa3655]

Thanks alot

[@user-wg5bk9dl4k]

Great , can you make a video for beginners in histopathology students video

[@SunflowerCupcake]

kzbin.info/www/bejne/r4K0Y3ejr5lljNU This is his benign skin histology video.

[@amaliyadipita6906]

👍🏾👍🏾👍🏾👍🏾👍🏾👍🏾❤️❤️❤️❤️