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• W2040659909 abstract "Le myxome des gaines nerveuses est une tumeur bénigne rare des extrémités, qui a longtemps été confondue avec le neurothécome. Nous en décrivons un cas exceptionnel par sa localisation à l’hyponychium. Une femme de 31 ans avait une tumeur distale de l’auriculaire droit, non douloureuse, évoluant depuis trois à quatre ans. Il s’agissait d’un nodule rond et ferme, hyponychial et débordant sur la pulpe. L’excision complète a été réalisée après découpage de la tablette distale. L’examen histologique a montré une tumeur myxoïde faite de lobules très bien limités, comprenant des cellules fusiformes pâles contenant de petites inclusions nucléaires. Ces cellules exprimaient la protéine S100, mais pas le CD34 ni l’antigène membranaire épithélial (EMA). L’excision était totale et une restitutio ad integrum a été obtenue. Cette tumeur est caractéristique du myxome des gaines nerveuses, qui est sans doute d’origine schwannienne, bien qu’il se distingue des schwannomes. Il est rare, survient après 35 ans et se localise préférentiellement aux extrémités des membres. La localisation sous-unguéale n’a été décrite qu’une fois, sous le nom de neurothécome. En fait, le neurothécome est très différent, plus cellulaire, n’exprimant pas la protéine S100, mais marqué par l’anticorps NKIC3 ; il survient chez des enfants ou de jeunes adultes, surtout au visage. Il a longtemps régné une confusion entre ces tumeurs, qui doivent aujourd’hui être parfaitement distinguées l’une de l’autre. Ces myxomes doivent être excisés en totalité car ils peuvent récidiver. On doit enfin les distinguer des autres tumeurs myxoïdes des doigts, qui peuvent parfois être malignes. Nerve sheath myxoma is a rare benign tumour of the extremities that was long confounded with neurothekeoma. Herein, we describe a rare case of interest because of its site on the hyponychium. A 31-year-old woman presented with a painless distal tumour on the right ring finger that had been present for 3 to 4 years. It consisted of a firm, round nodule under the nail and spreading to the fingertip. Complete excision was carried out after cutting away the distal nail plate. Histological examination revealed a myxoid tumour comprising very clearly delineated lobules containing pale fusiform cells with small nuclear inclusions. These cells expressed S100 protein but no CD34 or epithelial membrane antigen (EMA). Complete excision was performed and a full recovery was made. This type of tumour is characteristic of nerve sheath myxoma, and is almost certainly of Schwannian origin, although distinct from Schwannoma. It is rare, occurs after the age of 35 years and is preferentially located in the extremities of the limbs. There has only been one other description of its occurrence under the fingernail, in which it was described as neurothekeoma. However, neurothekeoma is entirely different, being more cellular, with no expression of protein S100, and marked by the NKIC3 antibody; it occurs in children or young adults, and is frequently found on the face. These two tumours were confused for some time, but today they must be completely distinguished from one another. These myxomas must be completely excised because of the risk of relapse. Finally, they should be distinguished from other myxoid tumours of the digits, certain of which can be malignant." @default.
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• W2040659909 date "2013-08-01" @default.
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• W2040659909 title "Myxome des gaines nerveuses de l’hyponychium" @default.
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• W2040659909 doi "https://doi.org/10.1016/j.annder.2013.04.074" @default.
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