Incidental Intercostal Intramuscular Myxoma With Fibrous Dysplasia in a Patient With Mazabraud's and McCune Albright Syndromes.

Ali S Tejani,Vishal Kukkar

doi:10.7759/cureus.22869

Abstract

Intramuscular myxoma is a rare entity that may present as single or multiple lesions in patients with Mazabraud’s syndrome and is characterized by intramuscular myxomas with fibrous dysplasia. Though intramuscular myxomas occur in large muscle groups, they can very rarely occur in the chest wall. We present the case of a 41-year-old woman with an incidentally discovered intercostal mass on magnetic resonance cholangiopancreatography (MRCP). Repeat MRI demonstrated a lobulated, T2-hyperintense intercostal lesion and demonstrated adjacent fibrous dysplasia of the ribs, consistent with the patient’s history of Mazabraud's and McCune Albright syndromes. Histopathological exam following surgical resection confirmed a diagnosis of intramuscular myxoma without the presence of sarcomatous changes. Though small, slow-growing intramuscular myxomas may be observed with conservative management in the absence of significant symptoms, surgical resection is warranted to prevent complications such as osseous erosion or nerve impingement.

Highlights

Though intramuscular myxomas occur in large muscle groups, they can very rarely occur in the chest wall
We present the case of a 41-year-old woman with an incidentally discovered intercostal mass on magnetic resonance cholangiopancreatography (MRCP)
We describe the case of a 41-year-old female patient with a history of Mazabraud’s and McCune Albright syndromes who presented with an incidentally discovered intercostal mass on magnetic resonance cholangiopancreatography (MRCP) with adjacent fibrous dysplasia of the ribs, which was found to be histologically consistent with an intramuscular myxoma

Summary

Introduction

Benign mesenchymal tumors that can occur in various anatomic locations either independently or as a constellation of pathologic syndromes. A 41-year-old woman with a history of Mazabraud’s and McCune Albright syndromes and known polyostotic fibrous dysplasia, multiple endocrinopathies (Cushing syndrome, status post adrenalectomy, and hypothyroidism), and multiple prior symptomatic myxomas, presented for the evaluation of an incidentally discovered right intercostal mass between the seventh and eighth ribs on MRCP performed for follow-up imaging of known pancreatic cysts and surveillance for intraductal papillary mucinous neoplasm. She notes that she has not had any recent pain associated with the right chest wall, and she has not noticed any enlarging, palpable mass. Her chest tube output gradually declined, and all chest tubes were removed without complication

Discussion

Findings

Conclusions

Disclosures