Malignant peripheral nerve‑sheath tumors in an adolescent patient with mosaic localized NF1: A case report

Hagizawa,Hiroki; Nagata,Shigenori; Wakamatsu,Toru; Imura,Yoshinori; Tanaka,Takaaki; Outani,Hidetatsu; Konishi,Eiichi; Naka,Norifumi; Tamiya,Hironari

doi:10.3892/mco.2019.1969

February-2020 Volume 12 Issue 2

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February-2020 Volume 12 Issue 2

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Case Report Open Access

Malignant peripheral nerve‑sheath tumors in an adolescent patient with mosaic localized NF1: A case report

Authors:
- Hiroki Hagizawa
- Shigenori Nagata
- Toru Wakamatsu
- Yoshinori Imura
- Takaaki Tanaka
- Hidetatsu Outani
- Eiichi Konishi
- Norifumi Naka
- Hironari Tamiya
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Affiliations: Department of Orthopedic Surgery, Osaka International Cancer Institute, Osaka 541‑8567, Japan, Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka 541‑8567, Japan, Department of Orthopedic Surgery, Osaka University Hospital, Suita, Osaka 565‑0871, Japan, Department of Pathology, Kyoto Prefectural University of Medicine, Kyoto 602‑8566, Japan

Copyright: © Hagizawa et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 155-159
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Published online on: December 17, 2019

https://doi.org/10.3892/mco.2019.1969
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Abstract

Malignant peripheral nerve‑sheath tumors (MPNSTs) are rare malignancies that are often observed in patients with neurofibromatosis type 1 (NF1). However, the occurrence of MPNST associated with mosaic localized NF1 is extremely rare. Previous reports have revealed that MPNST was associated with mosaic localized NF1 in only three patients who were >40 years of age. The present report details a 16‑year‑old man who presented with pain and a 3 cm mass on the medial side of the right knee. Magnetic resonance imaging revealed a circumscribed soft tissue tumor located in the subcutaneous tissue. His previous doctor believed that it was benign and conducted a marginal resection. However, postoperative histology results demonstrated spindle cell sarcoma, following which the patient was referred to The Osaka International Cancer Institute. Localized café‑au‑lait spots were identified in the affected leg, which inferred that the patient had NF1‑related MPNST. A wide resection was performed to completely resect the residual tumor; however, a definitive histological diagnosis was challenging due to the small residual tumor. Hence, the genomic mutations of NF1 in the regional café‑au‑lait spots were analyzed. The result revealed an NF1 microdeletion and a consistently limited expression of NF1 in the tumor sample. Finally, the patient was diagnosed with MPNST with mosaic localized NF1. Local recurrence and distant metastasis were not observed 1.5 years after surgery. In conclusion, the present report presented MPNST in an adolescent patient with mosaic localized NF1. The occurrence of MPNSTs correlated with mosaic localized NF1 is extremely rare. However, it is of high‑grade malignancy and therefore, its clinical features should be considered by orthopedists and pathologists.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Malignant peripheral nerve‑sheath tumors in an adolescent patient with mosaic localized NF1: A case report

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