What is your diagnosis?
Case for diagnosis. Infraorbital schwannoma
Irving Llibrán Reyna-Rodríguez, Sonia Chavez-Alvarez, Jorge Ocampo-Candiani
Autor para correspondência
Dermatology Department, Faculty of Medicine, Hospital Universitario “Dr. Jose E. Gonzalez”, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
Lido
7472
Vezesque se leu este artigo
3283
Total PDF
4189
Total HTML
Compartilhar estatÃsticas
array:24 [ "pii" => "S036505962100060X" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.08.014" "estado" => "S300" "fechaPublicacion" => "2021-05-01" "aid" => "341" "copyright" => "Sociedade Brasileira de Dermatologia" "copyrightAnyo" => "2021" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "crp" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "pt" => array:19 [ "pii" => "S266627522100062X" "issn" => "26662752" "doi" => "10.1016/j.abdp.2020.08.013" "estado" => "S300" "fechaPublicacion" => "2021-05-01" "aid" => "341" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "crp" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "pt" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Qual o seu diagnóstico?</span>" "titulo" => "Caso para diagnóstico. Pápula normocrômica assintomática na região bucinadora" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "tieneResumen" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "358" "paginaFinal" => "361" ] ] "contieneResumen" => array:1 [ "pt" => true ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1297 "Ancho" => 3175 "Tamanyo" => 253256 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A), Pápula normocrômica na região bucinadora direita. (B), Imagem dermatoscópica polarizada mostrando aspectos não característicos.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Irving Llibrán Reyna‐Rodríguez, Sonia Chavez‐Alvarez, Jorge Ocampo‐Candiani" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Irving Llibrán" "apellidos" => "Reyna‐Rodríguez" ] 1 => array:2 [ "nombre" => "Sonia" "apellidos" => "Chavez‐Alvarez" ] 2 => array:2 [ "nombre" => "Jorge" "apellidos" => "Ocampo‐Candiani" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S036505962100060X" "doi" => "10.1016/j.abd.2020.08.014" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S036505962100060X?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S266627522100062X?idApp=UINPBA00008Z" "url" => "/26662752/0000009600000003/v2_202105280710/S266627522100062X/v2_202105280710/pt/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S0365059621000799" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.06.024" "estado" => "S300" "fechaPublicacion" => "2021-05-01" "aid" => "360" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "sco" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Research Letter</span>" "titulo" => "Botulinum toxin-A: evaluation of the influence on the aspect of trunk scars" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "362" "paginaFinal" => "364" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2222 "Ancho" => 3167 "Tamanyo" => 338702 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Marking of BTA stitches with a schematic representation of the proposed methodology.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Renato Luiz Baldissera, Rafaela Ludvig Lehmkuhl, Juliano Vilaverde Schmitt, Deborah Skusa de Torre" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Renato Luiz" "apellidos" => "Baldissera" ] 1 => array:2 [ "nombre" => "Rafaela Ludvig" "apellidos" => "Lehmkuhl" ] 2 => array:2 [ "nombre" => "Juliano Vilaverde" "apellidos" => "Schmitt" ] 3 => array:2 [ "nombre" => "Deborah Skusa de" "apellidos" => "Torre" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275221000813" "doi" => "10.1016/j.abdp.2020.06.025" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221000813?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621000799?idApp=UINPBA00008Z" "url" => "/03650596/0000009600000003/v2_202106040718/S0365059621000799/v2_202106040718/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0365059621000660" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.07.013" "estado" => "S300" "fechaPublicacion" => "2021-05-01" "aid" => "347" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "crp" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Dermatology</span>" "titulo" => "Motorcycling can be dangerous: verrucous lichenoid reaction to a tattoo" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "355" "paginaFinal" => "357" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1590 "Ancho" => 905 "Tamanyo" => 215977 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Clinical aspect after a few weeks: verrucous appearance of the regions tattooed with red pigment.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Isadora Rosan, Ninoska Nieto-Salazar, Marcello Menta Simonsen Nico" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Isadora" "apellidos" => "Rosan" ] 1 => array:2 [ "nombre" => "Ninoska" "apellidos" => "Nieto-Salazar" ] 2 => array:2 [ "nombre" => "Marcello Menta Simonsen" "apellidos" => "Nico" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275221000680" "doi" => "10.1016/j.abdp.2020.07.021" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221000680?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621000660?idApp=UINPBA00008Z" "url" => "/03650596/0000009600000003/v2_202106040718/S0365059621000660/v2_202106040718/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">What is your diagnosis?</span>" "titulo" => "Case for diagnosis. Infraorbital schwannoma" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "358" "paginaFinal" => "361" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Irving Llibrán Reyna-Rodríguez, Sonia Chavez-Alvarez, Jorge Ocampo-Candiani" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Irving Llibrán" "apellidos" => "Reyna-Rodríguez" ] 1 => array:2 [ "nombre" => "Sonia" "apellidos" => "Chavez-Alvarez" ] 2 => array:4 [ "nombre" => "Jorge" "apellidos" => "Ocampo-Candiani" "email" => array:1 [ 0 => "jocampo2000@yahoo.com.mx" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Dermatology Department, Faculty of Medicine, Hospital Universitario “Dr. Jose E. Gonzalez”, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1297 "Ancho" => 3175 "Tamanyo" => 253256 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Skin-colored papule on the right cheek. (B) Polarized dermoscopic image showing non-characteristic features.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Case report</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 40-year-old male, with an unremarkable personal and family history, presented for evaluation of an asymptomatic papule located on his right cheek that had been present since childhood. He had not received any treatment. Physical examination revealed a solitary, circumscribed, firm, skin-colored, 4–6 mm papule (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). Dermoscopic (polarized mode, Dermlite) examination demonstrated non-specific erythema, normal pigmentary network without follicular plugging (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). An excisional biopsy of the lesion was performed.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Histopathology (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a> A and B) revealed an encapsulated neoplasm within the dermis; on higher magnification, we could see narrow, elongated, and wavy cells with an ill-defined cytoplasm, dense chromatin and tapered ends interspersed with collagen fibers. Immunohistochemical stains for S-100 and (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a> A and B) and Glial Fibrillary Acidic Protein (GFAP) (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a> C and D) were positive. Pathologic findings were consistent with tissue of Antoni B pattern. The patient had good healing of the site of excisional biopsy.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">What is your diagnosis?</span><p id="par0015" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">a)</span><p id="par0020" class="elsevierStylePara elsevierViewall">Dermal nevus</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">b)</span><p id="par0025" class="elsevierStylePara elsevierViewall">Sebaceous hyperplasia</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">c)</span><p id="par0030" class="elsevierStylePara elsevierViewall">Infraorbital schwannoma</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">d)</span><p id="par0035" class="elsevierStylePara elsevierViewall">Trichoepithelioma</p></li></ul></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="par0040" class="elsevierStylePara elsevierViewall">Schwannomas, also called neurilemmomas, are benign ectodermal neoplasms originated from peripheral, cranial, or autonomic nerve Schwann cell sheaths.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Male: Female ratio is 1:1 but some authors consider that women are more affected.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> Most of the extracranial schwannomas are present in the head and neck (25%–45%).<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a> These can develop from any of the 12 cranial nerves (mainly auditory nerve); except optic and olfactory (because they lack Schwann cells in their sheaths).<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> The trigeminal nerve is rarely associated with schwannomas; especially in the infraorbital nerve area. <a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> They present as a slow-growing mass, without pain or a neurological deficit.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Diagnosis is made with histopathology and clinical correlation. Histopathologically, Schwann cells can be seen as spindle-shaped cells in parallel rows forming a typical palisading pattern of Verocay bodies. Classification is based on cellularity: Antoni A (hypocellular) or Antoni B (hypercellular).<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> No fibroblasts, mast cells, neurilemmal, or endoneurial cells are present.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Possible clinical differential diagnoses in this location include dermal nevus, dermoid cyst, sebaceous hyperplasia, trichoepithelioma, and palisaded encapsulated neuroma (PEN). On histopathology the principal differential diagnosis is PEN (contains axons), both tumors are S-100 positive, schwannoma is positive for GFAP and negative for neurofilament while PEN is just the opposite.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Other less possible histopathological differential diagnoses are neurofibroma (lacks a capsule, contains mucopolysaccharide ground substance and fewer axons with myelin sheaths), traumatic neuroma (axonal and Schwann cells in addition to scarring and inflammatory cells), and leiomyoma (spindle cell lesion composed of muscle cells).<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,8</span></a> Extracranial schwannomas have a good prognosis with exclusively surgical treatment (approach according to size, extent, and anatomical location).<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Malignant transformation is extremely rare when presenting as an isolated lesion.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> The incidental finding of rare tumors like this infraorbital nerve schwannoma should make clinicians consider a greater spectrum of differential diagnosis for a unilateral skin-colored papule on the cheek of healthy middle-age patients.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Financial support</span><p id="par0045" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Authors' contributions</span><p id="par0050" class="elsevierStylePara elsevierViewall">Irving Llibrán Reyna-Rodríguez: Study conception and planning; preparation and writing of the manuscript; data collection, analysis, and interpretation; critical literature review.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Sonia Chavez-Alvarez: Study conception and planning; critical literature review; effective participation in research orientation; approval of the final version of the manuscript.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Jorge Ocampo-Candiani: Study conception and planning; critical literature review; effective participation in research orientation; approval of the final version of the manuscript.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of interest</span><p id="par0065" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres1521070" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1379246" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Case report" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "What is your diagnosis?" ] 4 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 5 => array:2 [ "identificador" => "sec0020" "titulo" => "Financial support" ] 6 => array:2 [ "identificador" => "sec0025" "titulo" => "Authors' contributions" ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflicts of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-06-29" "fechaAceptado" => "2020-08-26" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1379246" "palabras" => array:4 [ 0 => "Infraorbital schwannoma" 1 => "Neurilemmoma" 2 => "Schwannoma" 3 => "Tumor" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We report a 40-year-old man, with an unremarkable personal and family history, who presented for evaluation of an asymptomatic papule located on his right cheek. Histopathology revealed an encapsulated neoplasm within the dermis; composed by narrow, elongated, and wavy cells with an ill-defined cytoplasm, dense chromatin and tapered ends interspersed with collagen fibers. Pathologic findings were consistent with tissue of Antoni B pattern. The diagnosis was an infraorbital schwannoma. The incidental finding of rare tumors like this, should make clinicians consider a greater spectrum of differential diagnoses for a unilateral skin-colored papule on the cheek of patients.</p></span>" ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">How to cite this article: Reyna-Rodríguez IL, Chavez-Alvarez S, Ocampo-Candiani J. Case for diagnosis. Infraorbital schwannoma. An Bras Dermatol. 2021;96:358–61.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study conducted at the Dermatology Department, Faculty of Medicine, Hospital Universitario “Dr. Jose E. Gonzalez”, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1297 "Ancho" => 3175 "Tamanyo" => 253256 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Skin-colored papule on the right cheek. (B) Polarized dermoscopic image showing non-characteristic features.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1287 "Ancho" => 3175 "Tamanyo" => 889568 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A) A well-defined encapsulated tumor in the dermis (Hematoxylin & eosin, ×100). (B) Spindle Schwann cells with Verocay bodies, Anthony B pattern (Hematoxylin & eosin, ×200).</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 2921 "Ancho" => 3175 "Tamanyo" => 1670624 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A and B) Positive immunohistochemistry exam for S100. (C and D) Positive immunohistochemistry exam for GFAP.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Schwannoma of the upper lip: ultrasound, CT, and MRI findings" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Asaumi" 1 => "H. Konouchi" 2 => "K. Kishi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/joms.2000.9584" "Revista" => array:6 [ "tituloSerie" => "J Oral Maxillofac Surg." "fecha" => "2000" "volumen" => "58" "paginaInicial" => "1173" "paginaFinal" => "1175" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11021717" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An unusual case of schwannoma in the infraorbital region" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B. Pirimoglu" 1 => "M. Kantarci" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/SCS.0000000000004853" "Revista" => array:6 [ "tituloSerie" => "J Craniofac Surg." "fecha" => "2018" "volumen" => "29" "paginaInicial" => "e814" "paginaFinal" => "e815" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30320678" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A rare case of isolated schwannoma in infraorbital nerve" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.S. Choi" 1 => "S.M. Park" 2 => "C. Kyung-Un" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7181/acfs.2018.02033" "Revista" => array:6 [ "tituloSerie" => "Arch Craniofac Surg." "fecha" => "2018" "volumen" => "19" "paginaInicial" => "231" "paginaFinal" => "234" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30282436" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Extracranial head and neck schwannomas: a review of 8 years experience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Y.S. Leu" 1 => "K.C. Chang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/00016480260000157" "Revista" => array:6 [ "tituloSerie" => "Acta Otolaryngol." "fecha" => "2002" "volumen" => "122" "paginaInicial" => "435" "paginaFinal" => "437" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12126003" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infraorbital nerve schwannoma presenting as an upper lip mass in an adolescent boy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Y.O. Kok" 1 => "M.S. Yeo" 2 => "W. Nallathamby" 3 => "S.J. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/SAP.0b013e318248b8a2" "Revista" => array:6 [ "tituloSerie" => "Ann Plast Surg." "fecha" => "2013" "volumen" => "71" "paginaInicial" => "196" "paginaFinal" => "197" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23241763" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Schwannoma originating from the infraorbital nerve: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.S. Tezer" 1 => "M. Ozcan" 2 => "Ö Han" 3 => "A. Unal" 4 => "S. Ozlugedik" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.anl.2005.11.015" "Revista" => array:6 [ "tituloSerie" => "Auris Nasus Larynx." "fecha" => "2006" "volumen" => "33" "paginaInicial" => "343" "paginaFinal" => "345" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16413981" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Palisaded encapsulated (solitary circumscribed) neuroma: a review of 30 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Leblebici" 1 => "T.C. Savli" 2 => "B. Yeni" 3 => "M. Cin" 4 => "A.E.K. Aksu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/1066896919833172" "Revista" => array:6 [ "tituloSerie" => "Int J Surg Pathol." "fecha" => "2019" "volumen" => "27" "paginaInicial" => "506" "paginaFinal" => "514" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30834800" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Palisaded encapsulated neuroma (solitary circumscribed neuroma of skin) of the eyelid: report of two cases and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.R. Dubovy" 1 => "B.J. Clark" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bjo.85.8.949" "Revista" => array:6 [ "tituloSerie" => "Br J Ophthalmol." "fecha" => "2001" "volumen" => "85" "paginaInicial" => "949" "paginaFinal" => "951" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11466253" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osteoplastic maxillotomy approach for infraorbital nerve schwannoma, a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.A. Karkas" 1 => "S.A. Schmerber" 2 => "G.V. Bettega" 3 => "E.P. Reyt" 4 => "C.A. Righini" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/hed.20702" "Revista" => array:6 [ "tituloSerie" => "Head Neck." "fecha" => "2009" "volumen" => "30" "paginaInicial" => "401" "paginaFinal" => "404" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17657797" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical features and management of schwannoma affecting the upper and lower lips" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Sitenga" 1 => "G. Aird" 2 => "A. Vaudreuil" 3 => "C.J. Huerter" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ijd.13920" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol." "fecha" => "2018" "volumen" => "57" "paginaInicial" => "1047" "paginaFinal" => "1052" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29377087" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03650596/0000009600000003/v2_202106040718/S036505962100060X/v2_202106040718/en/main.assets" "Apartado" => array:4 [ "identificador" => "80633" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "What is your Diagnosis?" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03650596/0000009600000003/v2_202106040718/S036505962100060X/v2_202106040718/en/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S036505962100060X?idApp=UINPBA00008Z" ]
| Ano/Mês | Html | Total | |
|---|---|---|---|
| 2024 Novembro | 19 | 8 | 27 |
| 2024 Outubro | 98 | 91 | 189 |
| 2024 Setembro | 145 | 134 | 279 |
| 2024 Agosto | 161 | 139 | 300 |
| 2024 Julho | 153 | 123 | 276 |
| 2024 Junho | 131 | 82 | 213 |
| 2024 Maio | 109 | 78 | 187 |
| 2024 Abril | 120 | 86 | 206 |
| 2024 Março | 129 | 72 | 201 |
| 2024 Fevereiro | 153 | 84 | 237 |
| 2024 Janeiro | 109 | 53 | 162 |
| 2023 Dezembro | 75 | 57 | 132 |
| 2023 Novembro | 90 | 78 | 168 |
| 2023 Outubro | 78 | 72 | 150 |
| 2023 Setembro | 69 | 73 | 142 |
| 2023 Agosto | 59 | 39 | 98 |
| 2023 Julho | 111 | 43 | 154 |
| 2023 Junho | 107 | 54 | 161 |
| 2023 Maio | 78 | 21 | 99 |
| 2023 Abril | 58 | 21 | 79 |
| 2023 Março | 87 | 49 | 136 |
| 2023 Fevereiro | 71 | 42 | 113 |
| 2023 Janeiro | 60 | 43 | 103 |
| 2022 Dezembro | 72 | 43 | 115 |
| 2022 Novembro | 88 | 57 | 145 |
| 2022 Outubro | 109 | 62 | 171 |
| 2022 Setembro | 66 | 72 | 138 |
| 2022 Agosto | 54 | 55 | 109 |
| 2022 Julho | 58 | 61 | 119 |
| 2022 Junho | 73 | 67 | 140 |
| 2022 Maio | 93 | 48 | 141 |
| 2022 Abril | 87 | 65 | 152 |
| 2022 Março | 70 | 65 | 135 |
| 2022 Fevereiro | 47 | 53 | 100 |
| 2022 Janeiro | 79 | 91 | 170 |
| 2021 Dezembro | 74 | 61 | 135 |
| 2021 Novembro | 69 | 85 | 154 |
| 2021 Outubro | 83 | 93 | 176 |
| 2021 Setembro | 77 | 64 | 141 |
| 2021 Agosto | 72 | 54 | 126 |
| 2021 Julho | 73 | 60 | 133 |
| 2021 Junho | 139 | 100 | 239 |
| 2021 Maio | 102 | 96 | 198 |
| 2021 Abril | 284 | 329 | 613 |
| 2021 Março | 50 | 60 | 110 |
Mostrar tudo
