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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The cellular neurothekeoma is a rare benign tumor of uncertain histogenesis&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> It was first thought to be the same as nerve sheath myxoma&#44; but it is now known to be a different entity&#46; The tumor appears in young women in the first 3 decades of life as a single papular or nodular lesion&#44; of pale erythematous&#44; pink or normal skin color&#46; It arises on the head or neck&#46; Histologically it is a nonencapsulated tumor formed of epithelioid and spindle-shaped cells&#44; occasionally with poorly-defined margins&#46; It develops in the dermis and in the subcutaneous cellular tissue and can extend down to the muscle plane&#46; Occasionally&#44; a degree of cellular atypia has been described&#44; though this does not appear to affect the prognosis&#46; The treatment of choice is surgery&#59; recurrence is related to involvement of the surgical margins&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">In recent years there has been an increase in the use of imaging studies in dermatology&#44; not only as diagnostic tools but also to complete the preoperative workup for tumors&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;5</span></a> Dermatologic high-frequency ultrasound has shown the greatest development&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">We present the case of a woman of 51 years of age&#44; with a past medical history of fibromyalgia on treatment with paracetamol and diazepam&#46; She was seen for a lesion in the left supraciliary region that had appeared 2 years earlier and had grown progressively&#46; The lesion produced local pain&#46; Physical examination revealed a clearly delimited&#44; hard subcutaneous tumor with no changes in the overlying skin&#46; The lesion was more palpable than visible&#46; Skin ultrasound showed a clearly delimited hypoechoic lesion of 7&#46;51<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>5&#46;62<span class="elsevierStyleHsp" style=""></span>mm&#44; with no posterior acoustic enhancement or shadow&#59; the lesion was located in the dermis and reached the muscle plane but did not affect the bone &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#46; Doppler ultrasound showed no increased vascularity within the lesion or at its margins &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#46; Histopathology was compatible with a cellular neurothekeoma with cellular atypia&#46; It was decided to perform complete excision of the lesion&#44; which was found to reach the muscle plane&#46; The patient has been followed up in outpatients for 3 months and has presented no clinical signs of recurrence&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">High-frequency skin ultrasound was introduced recently to dermatology and it has been used as a technique to complement physical examination&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;5</span></a> Ultrasound has certain advantages compared with other imaging studies &#40;computed tomography &#91;CT&#93; and magnetic resonance &#91;MRI&#93;&#41; in the field of neoplastic skin disease&#58; it is a rapid and noninvasive technique that can be performed in the outpatient clinic&#44; avoiding delays&#44; and it offers a complete image of the lesion in real time&#59; it distinguishes between the layers of the skin and skin or nail lesions of less than 3<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">5</span>&#59; it is less costly<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a>&#59; it does not involve ionizing radiation&#44; and can therefore be used in children&#44; pregnant women&#44; and patients with pacemakers<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#59; and&#44; as with CT or MRI&#44; it provides information on the anatomy of the region&#44; thus being of considerable assistance when planning surgery&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;5</span></a> However&#44; further research is still needed to consolidate the technique and to create a library of ultrasound patterns and nomenclature common to the different disease processes&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Despite the above&#44; there are few references in the literature on the use of imaging studies in the workup for cellular neurothekeoma&#44;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;8</span></a> and none of these has used ultrasound&#46; CT shows neurothekeoma as a well-defined&#44; round or oval&#44; hypodense or isodense lesion&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7</span></a> The MRI image is isointense or hypointense in T1 and hyperintense in T2&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;8</span></a> Kamo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> used MRI in the preoperative workup of a cellular neurothekeoma with poorly-defined borders in the nasal region of a young patient and reported that it can be useful in cases of poorly defined lesions&#46; Finally&#44; positron emission tomography with fluorodeoxyglucose shows a homogeneous increase in metabolic uptake in the lesion&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In our case&#44; dermatologic high-frequency ultrasound enabled certain clinically common tumors to be ruled out &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; In addition&#44; it revealed that it was not a vascular or malignant lesion as&#44; in addition to the infiltrative features of the lesion&#44; there would have had to be evidence of increased vascularity of the lesion&#59; bone involvement was also ruled out&#44; which helped when planning surgery&#46; Recently we have also had the opportunity to use ultrasound to evaluate a microcystic adnexal carcinoma in the same anatomic region and with a similar clinical presentation&#46; That lesion presented as a hypoechoic tumor with infiltrating borders&#44; but in contrast to the neurothekeoma&#44; there were also hyperechoic spots &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#44; corresponding to the corneal cysts described in the histological study&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">In conclusion&#44; we have presented the ultrasound image of a cellular neurothekeoma located in the left ciliary region of a 51-year-old woman&#46; Although histopathology continues to be the gold standard for the definitive diagnosis&#44; and further research is necessary to establish a common ultrasound pattern of the neurothekeoma&#44; we consider dermatologic high-frequency ultrasound to be a noninvasive and rapid diagnostic tool that helps to distinguish this tumor from other subcutaneous lesions and that can define the lesion preoperatively&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Aguado Lobo M&#44; Echeverr&#237;a-Garc&#237;a B&#44; &#193;lvarez-Garrido H&#44; Borbujo J&#46; Neurotequeoma celular&#58; descripci&#243;n ecogr&#225;fica&#46; Actas Dermosifiliogr&#46; 2015&#59;106&#58;522&#8211;524&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#44; B-mode&#58; clearly defined&#44; hypoechoic lesion with no acoustic enhancement or shadow&#44; located in the dermis&#44; without affecting bone&#46; B&#44; Color Doppler&#58; This did not reveal vascularity within or at the periphery of the tumor&#46;</p>"
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          "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Source&#58; Echeverr&#237;a-Garc&#237;a et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Wortsman<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> and Alfageme&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Skin Tumors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Ultrasound Description&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Epidermal cyst&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dermal or subdermal tumor with variable interior pattern &#40;homogeneous&#44; heterogeneous&#41; and posterior enhancement and lateral oblique shadows&#46; It may show a drainage channel to the surface &#40;punctum&#41; as a hypoechoic line&#46; It is not usually vascular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Lipoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subcutaneous tumor of variable echogenicity &#40;it typically shows parallel hyperechoic lines&#41;&#44; with poor vascularity&#46; Compression is different to the adjacent fat&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Pilomatrixoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dermal or subdermal tumor with a hypoechoic border &#40;halo sign&#41; and with a hyperechoic interior due to calcifications that produce an acoustic shadow&#46; Doppler reveals vascularity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dermoid cyst&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Well-defined&#44; hypoechoic tumor adherent to deeper planes and that does not show posterior enhancement&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dermatofibroma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Poorly defined&#44; hypoechoic dermal tumor that does not usually present visible blood vessels&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Plexiform neurofibroma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Lesions with a hypoechoic periphery and hyperechoic center&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Cellular neurothekeoma<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Clearly defined&#44; hypoechoic dermal tumor with no posterior enhancement or acoustic shadow&#46; No increased vascularity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Microcystic adnexal carcinoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Hypoechoic tumor with infiltrating borders and containing hyperechoic spots&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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Case and Research Letters
Ultrasound Features of Cellular Neurothekeoma
Neurotequeoma celular: descripción ecográfica
M. Aguado Lobo
Autor para correspondencia
martaaguadolobo@yahoo.es

Corresponding author.
, B. Echeverría-García, H. Álvarez-Garrido, J. Borbujo
Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The cellular neurothekeoma is a rare benign tumor of uncertain histogenesis&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> It was first thought to be the same as nerve sheath myxoma&#44; but it is now known to be a different entity&#46; The tumor appears in young women in the first 3 decades of life as a single papular or nodular lesion&#44; of pale erythematous&#44; pink or normal skin color&#46; It arises on the head or neck&#46; Histologically it is a nonencapsulated tumor formed of epithelioid and spindle-shaped cells&#44; occasionally with poorly-defined margins&#46; It develops in the dermis and in the subcutaneous cellular tissue and can extend down to the muscle plane&#46; Occasionally&#44; a degree of cellular atypia has been described&#44; though this does not appear to affect the prognosis&#46; The treatment of choice is surgery&#59; recurrence is related to involvement of the surgical margins&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">In recent years there has been an increase in the use of imaging studies in dermatology&#44; not only as diagnostic tools but also to complete the preoperative workup for tumors&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;5</span></a> Dermatologic high-frequency ultrasound has shown the greatest development&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">We present the case of a woman of 51 years of age&#44; with a past medical history of fibromyalgia on treatment with paracetamol and diazepam&#46; She was seen for a lesion in the left supraciliary region that had appeared 2 years earlier and had grown progressively&#46; The lesion produced local pain&#46; Physical examination revealed a clearly delimited&#44; hard subcutaneous tumor with no changes in the overlying skin&#46; The lesion was more palpable than visible&#46; Skin ultrasound showed a clearly delimited hypoechoic lesion of 7&#46;51<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>5&#46;62<span class="elsevierStyleHsp" style=""></span>mm&#44; with no posterior acoustic enhancement or shadow&#59; the lesion was located in the dermis and reached the muscle plane but did not affect the bone &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#46; Doppler ultrasound showed no increased vascularity within the lesion or at its margins &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#46; Histopathology was compatible with a cellular neurothekeoma with cellular atypia&#46; It was decided to perform complete excision of the lesion&#44; which was found to reach the muscle plane&#46; The patient has been followed up in outpatients for 3 months and has presented no clinical signs of recurrence&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">High-frequency skin ultrasound was introduced recently to dermatology and it has been used as a technique to complement physical examination&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;5</span></a> Ultrasound has certain advantages compared with other imaging studies &#40;computed tomography &#91;CT&#93; and magnetic resonance &#91;MRI&#93;&#41; in the field of neoplastic skin disease&#58; it is a rapid and noninvasive technique that can be performed in the outpatient clinic&#44; avoiding delays&#44; and it offers a complete image of the lesion in real time&#59; it distinguishes between the layers of the skin and skin or nail lesions of less than 3<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">5</span>&#59; it is less costly<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a>&#59; it does not involve ionizing radiation&#44; and can therefore be used in children&#44; pregnant women&#44; and patients with pacemakers<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#59; and&#44; as with CT or MRI&#44; it provides information on the anatomy of the region&#44; thus being of considerable assistance when planning surgery&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;5</span></a> However&#44; further research is still needed to consolidate the technique and to create a library of ultrasound patterns and nomenclature common to the different disease processes&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Despite the above&#44; there are few references in the literature on the use of imaging studies in the workup for cellular neurothekeoma&#44;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;8</span></a> and none of these has used ultrasound&#46; CT shows neurothekeoma as a well-defined&#44; round or oval&#44; hypodense or isodense lesion&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7</span></a> The MRI image is isointense or hypointense in T1 and hyperintense in T2&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;8</span></a> Kamo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> used MRI in the preoperative workup of a cellular neurothekeoma with poorly-defined borders in the nasal region of a young patient and reported that it can be useful in cases of poorly defined lesions&#46; Finally&#44; positron emission tomography with fluorodeoxyglucose shows a homogeneous increase in metabolic uptake in the lesion&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In our case&#44; dermatologic high-frequency ultrasound enabled certain clinically common tumors to be ruled out &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; In addition&#44; it revealed that it was not a vascular or malignant lesion as&#44; in addition to the infiltrative features of the lesion&#44; there would have had to be evidence of increased vascularity of the lesion&#59; bone involvement was also ruled out&#44; which helped when planning surgery&#46; Recently we have also had the opportunity to use ultrasound to evaluate a microcystic adnexal carcinoma in the same anatomic region and with a similar clinical presentation&#46; That lesion presented as a hypoechoic tumor with infiltrating borders&#44; but in contrast to the neurothekeoma&#44; there were also hyperechoic spots &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#44; corresponding to the corneal cysts described in the histological study&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">In conclusion&#44; we have presented the ultrasound image of a cellular neurothekeoma located in the left ciliary region of a 51-year-old woman&#46; Although histopathology continues to be the gold standard for the definitive diagnosis&#44; and further research is necessary to establish a common ultrasound pattern of the neurothekeoma&#44; we consider dermatologic high-frequency ultrasound to be a noninvasive and rapid diagnostic tool that helps to distinguish this tumor from other subcutaneous lesions and that can define the lesion preoperatively&#46;</p></span>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Ultrasound Description&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Epidermal cyst&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dermal or subdermal tumor with variable interior pattern &#40;homogeneous&#44; heterogeneous&#41; and posterior enhancement and lateral oblique shadows&#46; It may show a drainage channel to the surface &#40;punctum&#41; as a hypoechoic line&#46; It is not usually vascular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Lipoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subcutaneous tumor of variable echogenicity &#40;it typically shows parallel hyperechoic lines&#41;&#44; with poor vascularity&#46; Compression is different to the adjacent fat&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Pilomatrixoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dermal or subdermal tumor with a hypoechoic border &#40;halo sign&#41; and with a hyperechoic interior due to calcifications that produce an acoustic shadow&#46; Doppler reveals vascularity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dermoid cyst&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Well-defined&#44; hypoechoic tumor adherent to deeper planes and that does not show posterior enhancement&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dermatofibroma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Poorly defined&#44; hypoechoic dermal tumor that does not usually present visible blood vessels&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Plexiform neurofibroma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Lesions with a hypoechoic periphery and hyperechoic center&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Cellular neurothekeoma<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Clearly defined&#44; hypoechoic dermal tumor with no posterior enhancement or acoustic shadow&#46; No increased vascularity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Microcystic adnexal carcinoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Hypoechoic tumor with infiltrating borders and containing hyperechoic spots&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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