J Korean Med Sci.  2003 Apr;18(2):295-298. 10.3346/jkms.2003.18.2.295.

Malignant Transformation of Intrathoracic Ancient Neurilemmoma in a Patient without Von Recklinghausen's Disease

• Chu YC
• Yoon YH
• Han HS
• Han JY
• Kim JM
• Park IS

• KMID: 2157640
• DOI: http://doi.org/10.3346/jkms.2003.18.2.295

Abstract

Malignant transformation of a neurilemmoma is an exceedingly rare event. We describe a case of intrathoracic ancient neurilemmoma undergoing a malignant change in a 39-yr-old man. The patient presented with right flank and chest pain for several months. Plain radiography and CT scan of the chest showed a soft tissue mass lesion at the extrapleural space with erosion of surrounding ribs at the right basal lung area. The excised mass was encapsulated and measured 4.5 x 3.5 x 2.3 cm. The cut surface showed grayish-white and glistening with a focal cystic change and hemorrhage. Necrosis was not seen. Histologically, the tumor showed the features of classic neurilemmoma composed of the Antoni type A and B areas with perivascular hyalinization. In addition, obviously histo-logically malignant foci manifested by presence of markedly increased cellularity with fascicular arrangement, active mitotic activity, hyperchromasia, and gradual loss of original neurilemmomatous feature were noted.

Keyword

Neurilemmoma; Cell Transformation, Neoplastic; Neoplastic Processes

MeSH Terms

Adult
Cell Transformation, Neoplastic*
Diagnosis, Differential
Human
Male
Neurilemmoma/complications
Neurilemmoma/pathology*
Neurofibromatosis 1/complications
Neurofibromatosis 1/pathology*
Thoracic Neoplasms/etiology
Thoracic Neoplasms/pathology*
Tumor Markers, Biological