Nerve Sheath Myxoma in Pregnancy: A Case Report

Author:

De Chiara Elena1,Vellone Valerio Gaetano2ORCID,Ferro Jacopo2,Trambaiolo Antonelli Chiara2,Piro Liliana3,Avanzini Stefano3ORCID,Prono Valentina4,Beccaria Andrea5,Muraca Monica5ORCID,Tallone Ramona5

Affiliation:

1. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Infantile Sciences, University of Genoa, 16126 Genoa, Italy

2. Pathology Unit, IRCCS Giannina Gaslini Institute, 16147 Genoa, Italy

3. Department of Pediatric Surgery, IRCCS Giannina Gaslini Institute, 16147 Genoa, Italy

4. Pediatric Radiology, IRCCS Giannina Gaslini Institute, 16147 Genoa, Italy

5. D.O.P.O. Clinic, Department of Pediatric Hematology and Oncology, IRCCS Giannina Gaslini Institute, 16147 Genoa, Italy

Abstract

Nerve sheath myxoma (NSM) is a rare benign peripheral nerve sheath tumor that affects young adults. NSMs are asymptomatic, slow-growing swellings located in the upper extremities, more rarely in the lower extremities. Given the high risk of recurrence, it is recommended to perform a complete exeresis. To our knowledge, the evolution and management of NMS during pregnancy have not been described yet. We report the first case of recurrent pretibial NSM in a pregnant girl and its follow-up and outcome during and after pregnancy. NSM is difficult to diagnose clinically or using imaging. The final diagnosis remains histopathological. It is known how various types of benign and malignant skin tumors can develop or change during pregnancy. With our case, however, we documented that pregnancy does not affect the growth and evolution of NSM. Given the benign nature of the lesions and their tendency to grow slowly, during pregnancy, follow-up of NSMs can be conducted through ultrasonography and surgical treatment postponed after delivery. Our case highlights the importance of careful monitoring and individualized decision making, especially in rare scenarios such as NSM, where data on the progression of benign lesions are limited. Our case highlights the importance of a careful monitoring and a tailored treatment in rare scenarios such as NSM, where data on the progression of benign lesions are limited. Considering the benign nature of the lesions and their tendency to grow slowly, follow-up of NSMs during pregnancy can be conducted through ultrasonography, and surgical treatment can be postponed after delivery.

Funder

Italian Ministry of Health with ‘2024 Current Research’ funds

Publisher

MDPI AG

Reference16 articles.

1. Harkin, J.C., and Reed, R.J. (1969). Tumors of the Peripheral Nervous System. Atlas of Tumo Pathology, Armed Forces Institute of Pathology.

2. Soft Tissue Sarcoma, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology;Randall;J. Natl. Compr. Canc Netw.,2018

3. The WHO Classification of Tumours Editorial Board (2020). Soft tissue and bone tumours. WHO Classification of Tumours, IARC Press. [5th ed.].

4. Nerve sheath myxoma: A clinicopathologic and immunohistochemical analysis of 57 morphologically distinctive, S-100 protein- and GFAP-positive, myxoid peripheral nerve sheath tumors with a predilection for the extremities and a high local recurrence rate;Fetsch;Am. J. Surg. Pathol.,2005

5. Nerve Sheath Myxoma (Neurothekeoma) of the Gingiva, A Case Report and Review of the Literature;Safadi;Head Neck Pathol.,2010

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