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Year : 1996  |  Volume : 62  |  Issue : 3  |  Page : 183-184

Multiple painful neurilemmomas

Correspondence Address:
F Laxman Mavarkar

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Source of Support: None, Conflict of Interest: None

PMID: 20948034

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A 40-year-old male with painful neurilemmoma is reported. Clinically the patient had multiple painful nodular lesions over the right lower limb. Histopathology confirmed the diagnosis of neurilemmoma. The probable mechanism for painful nodular presentation is highlighted.

Keywords: Neurilemmoma

How to cite this article:
Mavarkar F L. Multiple painful neurilemmomas. Indian J Dermatol Venereol Leprol 1996;62:183-4

How to cite this URL:
Mavarkar F L. Multiple painful neurilemmomas. Indian J Dermatol Venereol Leprol [serial online] 1996 [cited 2019 Dec 7];62:183-4. Available from: http://www.ijdvl.com/text.asp?1996/62/3/183/4372

  Introduction Top

Neurilemmoma represents a benign nerve sheath tumour derived from Schwann cells and occurring along the course of cranial, peripheral and sympathetic nerves.[1] Although lesions are usually asymptomatic some lesions may be painful or tender. We are reporting a case of multiple neurilemmomas because of presentation as painful nodules and paucity of reports in Indian literature.

  Case Report Top

A 40-year-old man presented with painful nodular lesions over the right lower limb of 1 year duration. There was no history of weakness, deformity or impaired sensation over that limb. On examination multiple, tender, subcutaneous nodular lesions of varying size from 2 x 2 cm to 4 cm and distributed in a linear pattern were present over the lateral aspect of the right foot, posterior aspect of the right lower leg and knee. There were no similar lesions or hyperpigmented lesions over the other part of the body. Systemic examination was unremarkable. Probable diagnosis of neurilemmoma was made depending upon the clinical features.

Routine haematological and urine examinations were within normal limits. Histopathological examination of nodular lesion revealed findings consistent with the diagnosis of neurilemmoma [Figure - 1].

  Discussion Top

Neurilemmoma may occur in any age group, but most lesions appear between the ages of 30 and 60.[3] It arises most frequently from the acoustic nerve and the lesions are usually solitary, multiple lesions may occur in association with multiple neurofibromatosis.[2] In our case there were no features suggestive of neurofibromatosis.

Although they are usually asymptomatic some lesions may be painful or tender. Deep neurilemmomas are symptomatic by virtue of their large size and impingement on neighbouring structures.[4] This may be the reason for pain as presenting feature in our case.

Inspite of their origin from the nerve sheath, neurilemmomas seldom compromise nerve function.[3] But rarely mascular atrophy may occur in multiple neurilemmomas.[5] Malignant change may also occur rarely, usually in cases associated with Von Recklinghausen's disease.

  References Top

1.Stout AP. The peripheral manifestation of the specific nerve sheath tumor (neurilemmoma). Am J Cancer 1935;24:751.  Back to cited text no. 1    
2.Caro WA, Bronstein BR. Tumors of the skin. In: Moscella SL, Hurley HJ, editors. Dermatology. Philadelphia: Saunders, 1985:1533-638.  Back to cited text no. 2    
3.Das Gupta TK, Brasfield RD, Strong EW, et al. Benign solitary Schwannomas (Neurilemmomas). Cancer 1969;24:355.  Back to cited text no. 3  [PUBMED]  
4.Enzinger FM, Weiss SW. Benign tumors of the peripheral nerve. In: Soft tissue tumors. Missowri: CV Mosby, 1988:719-81.  Back to cited text no. 4    
5.Misra RS, Ramesh V, Mukherjee, et al. Multiple neurilemmomas with mascular atrophy. Ind J Dermatol Venereol Leprol 1985;51:46-7.  Back to cited text no. 5    


[Figure - 1]


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