Cellular Schwannoma Mimicking a Nodular Melanoma on the Sole of the Foot, an Avoidable Diagnostic Pitfall

Author:

Ruz Portero Begoña1ORCID,García de Sola Llamas Carmen2,Pérez Pérez Manuel3,Sánchez Bernal María Luisa2,Moreno Ramírez David1,Ríos Martín Juan José2

Affiliation:

1. Department of Dermatology, Hospital Universitario Virgen Macarena, Seville, Spain;

2. Department of Pathology, Hospital Universitario Virgen Macarena, Seville, Spain; and

3. Pathological Anatomy Laboratory of Dr Hugo Galera, Seville, Spain.

Abstract

Abstract: We report a rare case of cellular schwannoma (CS) manifesting as an ulcerated nodular lesion, mimicking spindle cell melanoma on the sole of the foot. CS, a benign variant of schwannoma, typically occurs in deep soft tissues but can rarely present cutaneously. The diagnosis of CS heavily relies on histopathological examination and immunohistochemical staining for specific markers such as SOX10 and S100. In this case, initial clinical suspicion of nodular melanoma was confirmed on biopsy, which revealed a spindle cell neoplasm positive for SOX10 and negative for melanocytic markers. Misdiagnosis of nodular melanoma was averted through complete excision. CS diagnosis demands careful consideration due to its resemblance to other spindle cell neoplasms, especially melanoma. Meticulous histopathological evaluation and immunostaining are important to differentiate CS from similar lesions, ensuring accurate diagnosis and appropriate management. This report contributes valuable insights into the diagnostic challenges and management of CS, particularly in unusual cutaneous presentations.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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