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Washington University Experience | NEOPLASMS - CRANIAL AND PARASPINAL NERVEs | Schwannoma | 10D Psammomatous Melanotic Schwannoma (Case 10) MIB 1

Not shown: A melan-A stain supports the positive HMB marker for melanin. Staining for chromogranin, CAM 5.2, EMA, and GFAP show no significant immunoreactivity within the tumor. ---- Comment: Based on histomorphologic features and immunostaining profile this neoplasm is most consistent with a psammomatous melanotic schwannoma. These tumors tend to be more aggressive than conventional schwannomas with over 10% following a malignant course. Approximately 50% of patients with psammomatous tumors have Carney complex, an autosomal-dominant disorder. Manifestations of Carney complex include endocrine over-activity, such as Cushing syndrome associated with multinodular adrenal hyperplasia and acromegaly due to pituitary adenoma, as well as lentiginous facial pigmentation and cardiac myxoma.

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