Cutaneous metastases of malignant peripheral nerve sheath tumor: Ineffectiveness of intralesional methotrexate

Claire E Hannah; Molly S Moye; Vincent Liu; Mohammed M Milhem; Karolyn A Wanat

doi:10.1016/j.jdcr.2018.04.011

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Cutaneous metastases of malignant peripheral nerve sheath tumor: Ineffectiveness of intralesional methotrexate

Journal article

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Cutaneous metastases of malignant peripheral nerve sheath tumor: Ineffectiveness of intralesional methotrexate

Claire E Hannah, Molly S Moye, Vincent Liu, Mohammed M Milhem and Karolyn A Wanat

JAAD Case Reports, Vol.4(7), pp.716-718

08/01/2018

DOI: 10.1016/j.jdcr.2018.04.011

PMCID: PMC6098197

PMID: 30128346

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Published (Version of record)JAAD Case Reports. 4(7),(2018) pp. 716-718.

Abstract

Introduction: Malignant peripheral nerve sheath tumor (MPNST) is an uncommon, aggressive sarcoma that arises from peripheral nerves and metastasizes hematogenously, most often to lung and bone. Approximately half of MPNSTs arise from plexiform neurofibromas in patients with neurofibromatosis type I (NF1). The remaining half occur sporadically, 10% of which arise from previously irradiated tissue. The epithelioid variant of MPNST is uncommon, accounting for less than 5% of cases. The most important aspect of treatment for MPNST is achieving clear surgical margins, as survival decreases dramatically with positive margins. Similar to other soft tissue sarcomas (STS), adjunctive chemoradiotherapy is used if wide margins cannot be achieved, even though MPNST is notoriously resistant to these therapies; the average 5-year survival rate for patients with MPNST is 50% to 60%, with even lower rates for metastatic disease. There are only 2 reports of MPNST metastasizing to the skin, and there are no reports of using intralesional methotrexate to slow progression of cutaneous metastases.

Dermatology

cutaneous metastasis

intralesional methotrexate

malignant peripheral nerve sheath tumor

methotrexate

sarcoma

MPNST

STS

neurofiromatosis type 1

tyrosine kinase inhibitor

TKI

case studies

soft tissue sarcoma

NF1

OAfund

Details

Title: Subtitle: Cutaneous metastases of malignant peripheral nerve sheath tumor: Ineffectiveness of intralesional methotrexate
Creators: Claire E Hannah - University of Iowa
Molly S Moye
Vincent Liu - University of Iowa
Mohammed M Milhem - University of Iowa
Karolyn A Wanat - University of Iowa
Resource Type: Journal article
Publication Details: JAAD Case Reports, Vol.4(7), pp.716-718
DOI: 10.1016/j.jdcr.2018.04.011
PMID: 30128346
PMCID: PMC6098197
ISSN: 2352-5126
Grant note: Funding: None Competing Interests: None declared.
Language: English
Date published: 08/01/2018
Academic Unit: Dermatology
Record Identifier: 9983557597602771

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