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September 1977

Pain With Synoviomas

Author Affiliations

New Orleans

Arch Dermatol. 1977;113(9):1297-1298. doi:10.1001/archderm.1977.01640090145036

To the Editor.—  Ever since Kersting and Helwig1 noted pain caused by eccrine spiradenomas, the association has been firmly established for certain nonneural lesions. For neural lesions, the solitary glomus tumor had long earned a reputation for exquisite pain. Three painful subcutaneous neurolemomas in a patient with neurofibromatosis,2 the traumatic neuroma arising in instances of disorganized nerve repair,3 and examples of Morton's neuroma4 further emphasize this symptom association with nerve lesions. During the past 50 years, data have been accumulating suggesting the surprising contention that synovial sarcomas may have a place in the spectrum of nerve tumors. Although a little less than half of these cancers are painful, 18.3% have pain before emergence of other signs and symptoms,5 indicating that the tissue giving rise to the cancer must be in especially close proximity to the nerves. Gross continuity with nerves, histologic documentation of unmyelinated nerves

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