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Neurofibrosarcoma
Etiology

Associated with neurofibromatosis, type 1, with mutation in NF1 locus and disruption of neurofibromin production
Usually arise de novo, rather than from preexisting neurofibroma.
Pathogenesis

Proliferation of Schwann cells,
Epidemiology

May be sporadic
Frequent complication of neurofibromatosis, type 1.
Disease of adults; predominantly associated with peripheral nerves (not cranial).
General Gross Description

Associated with a nerve which disappears into the neoplasm
Poorly circumscribed, fleshy, frequently necrotic and hemorrhagic lesion
•Examples:
Neurofibrosarcoma
General Microscopic Description

Cellular, pleomorphic, mitotically active neoplasm arranged in fascicles
Cells have spindly, sometimes wavy nuclei
Epithelial and other mesenchymal components such as skeletal muscle, cartilage or bone may be seen.
S-100 positive.
•Examples:
Clinical Correlation

Aggressive neoplasms requiring surgical and/or radiation therapy for local disease
Metastasize via the blood stream to lungs mandating multi-agent chemotherapy
Prognosis worsens with tumor size, tumor grade, and age of the patient
Location may also have an impact on resectability.
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1353.

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Neurofibrosarcoma
Synopsis by: Melinda Sanders M.D, (TX0500M95403)[554]
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