From the Section of Pediatric Orthopedic Surgery, William Beaumont Hospital, Royal Oak, MI, and the Department of Orthopedic Surgery, Oakland University William Beaumont School of Medicine, Rochester, MI.
J Am Acad Orthop Surg Glob Res Rev. 2021 Jan 19;5(1):e20.00099. doi: 10.5435/JAAOSGlobal-D-20-00099.
Intramuscular myxoma is a rare benign tumor that presents as a slow-growing, deeply seated mass confined within a skeletal muscle. Histologically, these lesions most resemble umbilical cord tissue. They mostly occur in people between 40 and 70 years old, with a 57% female predilection. These tumors are very rare in children. Only one pediatric intramuscular myxoma case is reported in the literature. The goal of this study is to report the case of a 13-year-old girl who presented to our hospital emergency department in 2018 with right hip pain, elevated inflammatory markers, and fever; her initial differential diagnosis was hip septic arthritis, pelvic osteomyelitis, and pelvic abscess. A pelvic MRI revealed a well-defined enhancing round lesion in the right obturator internus muscle. The diagnosis was conformed with a CT-guided core biopsy. The patient's symptoms improved with conservative management, and she continues to be doing well 2 years later. Pediatric pelvic intramuscular myxomas are extremely rare; however, they can have a presentation that mimic a more serious condition such as hip septic arthritis, pelvic osteomyelitis, and pelvic abscess and should be considered in the differential diagnosis in a pediatric patient presenting with hip pain.
肌内黏液瘤是一种罕见的良性肿瘤,表现为生长缓慢、局限于骨骼肌内的深部肿块。组织学上,这些病变最类似于脐带组织。它们主要发生在 40 至 70 岁之间的人群中,女性发病率为 57%。这些肿瘤在儿童中非常罕见。文献中仅报道了一例儿童肌内黏液瘤病例。本研究的目的是报告一例 13 岁女孩的病例,她于 2018 年因右髋部疼痛、炎症标志物升高和发热就诊于我院急诊科;最初的鉴别诊断为髋部化脓性关节炎、骨盆骨髓炎和骨盆脓肿。骨盆 MRI 显示右侧闭孔内肌内有一个界限清楚的增强圆形病变。诊断通过 CT 引导下的核心活检得到证实。患者的症状经保守治疗后得到改善,2 年后仍情况良好。儿童盆腔肌内黏液瘤极为罕见;然而,它们的表现可能类似于更严重的疾病,如髋部化脓性关节炎、骨盆骨髓炎和骨盆脓肿,在儿童出现髋部疼痛时应考虑将其纳入鉴别诊断。