Journal of cutaneous pathology
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Review Case Reports
Non-sentinel lymph node involvement in a patient with an atypical Spitz tumor and a positive sentinel node. Report of a case and review of the literature.
We report a 20-year-old male patient with an atypical Spitz tumor, located in the dorsal aspect of his left hand, and a positive sentinel axillary lymph node. After lymphadenectomy, 1 of 23 non-sentinel lymph nodes excised was found to contain small multiple deposits of large spindle atypical melanocytes. Reviewing the pertinent literature, 5 of 29 patients with atypical Spitz tumors and positive sentinel nodes who had undergone lymphadenectomy have shown non-sentinel node involvement (17.2%), a proportion similar to that reported in melanoma patients. The exact nature of atypical Spitz tumors and the interpretation of cell deposits detected in sentinel nodes are still debated; data regarding the non-sentinel lymph node involvement in patients with atypical Spitz tumors may contribute to better understand the real biological potential of such tumors.
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Neural fibrolipoma, also known as lipofibromatous hamartoma of nerves and neurolipomatosis, is a rare subcutaneous benign lesion involving the upper extremity with a marked predilection for median nerve. In one-third of the cases, it is associated with macrodactyly (enlargement of one or several digits of hands or feet), diminished sensation, paraesthesias and compression neuropathy. A 23-year-old male presented with a gradually increasing mass in the right palm without associated macrodactyly or neurodeficit. ⋯ Limited excision was the mainstay of conservative treatment. Neural fibrolipomas are a rare entity. Knowledge of characteristic histological and radiological findings is necessary for diagnosis and treatment.