Falavigna Asdrubal, Righesso Orlando, Volquind Daniel, Teles Alisson Roberto
Department of Neurosurgery, University of Caxias do Sul, Caxias do Sul, Brazil.
Eur Spine J. 2009 Jul;18 Suppl 2(Suppl 2):245-9. doi: 10.1007/s00586-009-0933-9. Epub 2009 Mar 20.
Myxoma is a neoplasm of mesenchymal origin composed of undifferentiated stellate cells in a myxoid stroma. This tumor can develop in a variety of locations. Myxomas that arise from skeletal muscles are called intramuscular myxomas. They usually occur in large skeletal muscles. Only ten cases of these benign tumors involving the neck muscles were reported in literature. Of them, only three were located at the paraspinal muscles. A 64-year-old woman presented with occipital and neck pain over 5 years noted an expansive painful lesion located at posterior cervical region with progressive volume increase in the last 12 months. Image exams revealed a large mass located in the left posterior region of the neck in contact with the C2, C3 and C4 laminae with no invasion of the vertebrae. Tumor total removal was performed through normal muscle margins and the vertebral periosteum was scraped. The tumor was encapsulated, lobulated with a gray-white appearance. The histological examination yielded the diagnosis of intramuscular myxoma. Follow-up at 1 year showed complete resolution of preoperative symptoms and no evidence of local recurrence. In conclusion, although rare, intramuscular myxoma should be included in differential diagnosis of cervical paraspinal tumors. We reported the fourth case of intramuscular myxoma in the paraspinal musculature of the neck. Despite its benign characteristics, local recurrence was reported after subtotal resection. Tumor total removal should be the goal of surgery.
黏液瘤是一种间叶组织来源的肿瘤，由黏液样基质中的未分化星状细胞组成。这种肿瘤可发生于多种部位。起源于骨骼肌的黏液瘤称为肌内黏液瘤。它们通常发生于大的骨骼肌。文献中仅报道了10例累及颈部肌肉的此类良性肿瘤。其中，仅3例位于椎旁肌。一名64岁女性，5年来一直有枕部和颈部疼痛，发现颈后部有一个逐渐增大的疼痛性肿物，在过去12个月中体积不断增大。影像学检查显示，颈部左后部有一个大肿块，与C2、C3和C4椎板相连，未侵犯椎体。通过正常肌肉边缘进行肿瘤全切，并刮除椎骨骨膜。肿瘤有包膜，呈分叶状，外观灰白色。组织学检查确诊为肌内黏液瘤。1年的随访显示术前症状完全缓解，无局部复发迹象。总之，尽管肌内黏液瘤罕见，但在颈椎旁肿瘤的鉴别诊断中应予以考虑。我们报道了颈部椎旁肌肉组织中第4例肌内黏液瘤。尽管其具有良性特征，但据报道次全切除后仍有局部复发。手术的目标应是肿瘤全切。
