Abstract
Background:Cellular myxoma is a histopathologically distinctive benign neoplasm, which has often been categorized among the broad category of benign mesenchymal tumors with myxoid stroma and fibroblast- and/or myofibroblast-like cells. These tumors can arise in any of the large muscles and are usually found in the thigh, shoulder, buttocks, and upper arm, and more rarely in the head and neck or in small muscles of the hand.Case Description:Here we illustrate the case of a 57-year-old female with a spinal lesion, who initially presented with complaints of vague pelvic discomfort but no focal neurological deficits. Imaging revealed a sharply demarcated paraspinal lesion concerning for a tumorous growth. The lesion was excised in toto and a detailed immuno-histopathological analysis was performed revealing the diagnosis of a cellular myxoma. Postoperative imaging showed a gross total resection and the patient is under clinical surveillance since, with no signs of recurrence after 42 months.Conclusion:Although very rare, this entity should be considered in the differential diagnosis of any spinal and paraspinal mass to allow for adequate treatment, which requires wide excision with clean margins to avoid any local recurrence.
Highlights
ConclusionThis entity should be considered in the differential diagnosis of any spinal and paraspinal mass to allow for adequate treatment, which requires wide excision with clean margins to avoid any local recurrence
Cellular myxoma is a histopathologically distinctive benign neoplasm, which has often been categorized among the broad category of benign mesenchymal tumors with myxoid stroma and fibroblast‐ and/or myofibroblast‐like cells
A tumor of adulthood,[5] with virtually no reported examples in children and adolescents,[7] it is characterized by abundant myxoid matrix, a poorly developed vasculature,[1] and a small number of inconspicuous stellate‐ or spindle‐shaped fibroblast‐like cells.[20]
Summary
This entity should be considered in the differential diagnosis of any spinal and paraspinal mass to allow for adequate treatment, which requires wide excision with clean margins to avoid any local recurrence. Intramuscular myxomas show focal areas of hypercellularity and hypervascularity These foci show a distinct lack of nuclear atypia, necrosis, and mitotic activity, and bear no prognostic significance. The mass was localized immediately adjacent to the posterior elements (lamina and spinous process) and was deeply seeded in the right multifidus muscle adjacent to the L5 inferior articular process. It measured approximately 3.0 × 3.0 × 3.5 cm in size on T1 postcontrast images [Figure 1]. As the lesion was concerning for a neoplasm, the patient was counseled and advised to pursue a histopathological diagnosis to direct further treatment options.
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