Abstract
Purpose
Intramuscular myxoma (IM) is a benign, soft tissue neoplasm of mesenchymal origin. We report our experience with this tumour.
Method
This clinical study comprised 11 cases of IM that were operated on between March 2008 and June 2016. Tumour location and size, results of pre-operative radiological studies, preop-erative biopsies, pathology examinations, applied surgical method and post-operative complications were reported for all patients.
Results
In total, nine patients with 11 IMs with a mean age of 60.0 years were assessed. Mean follow-up was 39.2 months. Tumours were located in the right thigh (5 patients, 7 IM), left gluteal area (2 patients, 2 IM), right gluteal area (1 IM) and left thigh (1 IM) ranging from 2 × 1 cm to 10 × 17 cm Pre-operative radiological diagnoses were cystic lesion, abscess, bursitis, fibrosarcoma, fibroma, lipoma, malign mesenchymal tumour and IM. Pre-operative biopsy was performed for five cases. All tumours were removed via simple excision and were pathologically consistent with IM. No complication or recurrence was observed during the follow-up period.
Conclusion
IM is a relatively rare benign tumour, the pre-operative diagnosis of which using radiological and clinical methods is quite difficult, creating pre-operative diagnostic confusion. It is generally diagnosed by microscopic examination. Simple excision with a small margin of surrounding tissue is considered to be sufficient for its treatment.
Similar content being viewed by others
References
Stout A (1948) Myxoma: the tumor of primitive mesenchyme. Ann Surg 127(4):706–719
Nielsen GP, O’Connell JX, Rosenberg AE (1998) IM: a clinicopathologic study of 51 cases with emphasis on hypercellular and hypervascular variants. Am J Surg Pathol 22(10):1222–1227
Murphey MD, McRae GA, Fanburg-Smith JC, Levine AM, Aboulafia AJ (2002) Imaging of soft-tissue myxoma with emphasis on CT and MR and comparison of radiologic and pathologic findings. Radiology 225(1):215–224
Nishio J, Naito M (2012) FDG PET/CT and MR imaging of IM in the gluteus maximus. World J Surg Oncol 10(1):132
van Roggen JF, McMenamin ME, Fletcher CD (2001) Cellular myxoma of soft tissue: a clinicopathological study of 38 cases confirming indolent clinical behaviour. Histopathology 39(3):287–297
Orlandi A, Bianchi L, Marino B, Spagnoli LG, Nini G (1995) IM of the face: an unusual localization. A clinicopathological study. Dermatol Surg 21(3):251–254
Charron P, Smith J (2004) IMs: a clinicopathologic study with emphasis on surgical management. Am Surg 70(12):1073–1077
Kemah B, Soylemez MS, Ceyran B, Şenol S, Mutlu S, Özkan K (2014) A case of IM presenting as a swollen shoulder: a case report. J Med Case Rep 8(1):441
Miettinen M, Hockerstedt K, Reitamo J (1985) Intramuscular myxoma -a clinicopathological study of twenty-three cases. Am J Clin Pathol 84(3):265–272
Delaney D, Diss TC, Presneau N, Hing S, Berisha F, Idowu BD, O’Donnell P, Skinner JA, Tirabosco R, Flanagan AM (2009) GNAS1 mutations occur more commonly than previously thought in IM. Mod Pathol 22(5):718–724
Luebke AM, Gocke C, Priemel M, Grob TJ, Zustin J (2012) Intramuscular myxoma of the lower leg. Pathologe 34(4):360–363
Walther I, Walther BM, Chen Y, Petersen I (2014) Analysis of GNAS1 mutations in myxoid soft tissue and bone tumors. Pathol Res Pract 210(1):1–4
Zoccali C, Teori G, Prencipe U, Erba F (2009) Mazabraud’s syndrome: a new case and review of the literature. Int Orthop 33(3):605–610
Abu Hassan FO, Shomaf M (2009) Intramuscular myxoma of the hypothenar muscles. Strateg Trauma Limb Reconstr 4(2):103–106
Li G, Jiang W, Li W, Li J (2014) Intramuscular myxoma of the hyoglossus muscle: a case report and literature review. Oncol Lett 7(5):1679–1682
Girish G, Jamadar DA, Landry D, Finlay K, Jacobson JA, Friedman L (2006) Sonography of IMs: the bright rim and bright cap signs. J Ultrasound Med 25(7):865–869, quiz 870-1
Bancroft LW, Kransdorf MJ, Menke DM, O’Connor MI, Foster WC (2002) IM: characteristic MR imaging features. AJR Am J Roentgenol 178(5):1255–1259
Luna A, Martinez S, Bossen E (2005) Magnetic resonance imaging of IM with histological comparison and a review of literature. Skelet Radiol 34(1):19–28
Petscavage-Thomas JM, Walker EA, Logie CI, Clarke LE, Duryea DM, Murphey MD (2014) Soft-tissue myxomatous lesions: review of salient imaging features with pathologic comparison. Radiographics 34(4):964–980
Allen PW (2000) Myxoma is not a single entity: a review of the concept of myxoma. Ann Diagn Pathol 4(2):99–123
Hashimoto H, Tsuneyoshi M, Daimaru Y, Enjoji M, Shinohara N (1986) Intramuscular myxoma: a clinicopathologic, immunohistochemical, and electron microscopic study. Cancer 58(3):740–747
Yaligod V, Ajoy SM (2013) Intramuscular myxoma - a rare tumor. J Orthop Case Rep 3(4):38–41
Kasraeian S, Allison DC, Ahlmann ER, Fedenko AN, Menendez LR (2010) A comparison of fine-needle aspiration, core biopsy, and surgical biopsy in the diagnosis of extremity soft tissue masses. Clin Orthop Relat Res 468(11):2992–3002
Dupuy DE, Rosenberg AE, Punyaratabadhu T, Tan MH, Mankin HJ (1998) Accuracy of CT-guided needle biopsy of musculoskeletal neoplasms. AJR Am J Roentgenol 171:759–762
van Roggen JFG, Hogendoorn PC, Fletcher CD (1999) Myxoid tumours of soft tissue. Histopathology 35(4):291–312
Bui MM, Smith P, Agresta SV, Cheong D, Letson GD (2008) Practical issues of intraoperative frozen section diagnosis of bone and soft tissue lesions. Cancer Control 15(1):7–12
Ferreiro JA, Myers JL, Bostwick DG (1995) Accuracy of frozen section diagnosis in surgical pathology: review of a 1-year experience with 24,880 cases at Mayo Clinic Rochester. Mayo Clin Proc 70(12):1137–1141
Ozawa H, Fujii M, Tomita T, Ogawa K (2004) Intramuscular myxoma of scalene muscle: a case report. Auris Nasus Larynx 31(3):319–322
McCook TA, Martinez S, Korobkin M, Ram PC, Bowen JH, Breiman RS, Harrelson JM, Gehweiler JA Jr (1981) Intramuscular myxoma: radiographic and computed tomographic findings with pathologic correlation. Skelet Radiol 7(1):15–19
Papadogeorgakis N, Petsinis V, Nikitakis N, Goutzanis L, Alexandridis C (2009) Intramuscular myxoma of the masseter muscle: a case report. Oral Maxillofac Surg 13(1):37–40
Patsiaoura K, Anagnostou E, Benis N (2010) Intramuscular myxoma of the nasal vestibule. Auris Nasus Larynx 37(1):100–102
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of ınterest
None.
Funding
None.
Ethical approval
Not required.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Baltu, Y., Arikan, Ş.M., Dölen, U.C. et al. Intramuscular myxoma: clinical and surgical observation notes on eleven cases. International Orthopaedics (SICOT) 41, 837–843 (2017). https://doi.org/10.1007/s00264-016-3396-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-016-3396-8