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Off-Center Fold
January 2009

Subcutaneous Nodules in an Infant—Diagnosis

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Arch Dermatol. 2009;145(1):77-82. doi:10.1001/archdermatol.2008.559-b

Histopathologic analysis revealed a dermal tumor composed of small blue cells arranged in cords and islands. Tumor cells were noted to palisade around fibrillar eosinophilic material. Immunohistochemical staining revealed tumor cells positive for neuron-specific enolase (NSE) and neurofilament.

Computed tomography of the chest and pelvis revealed a 4.2-cm right suprarenal mass consistent with primary neuroblastoma with diffuse liver, lung, splenic, and subcutaneous metastases. Metaiodobenzylguanidine scan showed involvement of the bones of the lower extremities, humeri, right pelvis, and cervical vertebrae. Magnetic resonance imaging of the head showed involvement of the calvarium, orbits, cerebellum, right temporal lobe, and facial bones and soft tissues. Bilateral bone marrow biopsy specimens proved negative for tumor.

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