Patel Sabina, Suji Trisha, Pang Graeme, Alg Varinder S, Visagan Ravindran, Reisz Zita, Lavrador Jose P, Kailaya-Vasan Ahilan, Grahovac Gordan
King's Neuro Lab, Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, UK.
Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, UK.
J Surg Case Rep. 2022 May 31;2022(5):rjac221. doi: 10.1093/jscr/rjac221. eCollection 2022 May.
Intramuscular myxomas are rare, benign mesenchymal tumours, occurring predominantly in large skeletal muscles as large, slow-growing and painless masses. Spinal occurrence is rare, and may present incidentally, or diagnosed via localized symptoms secondary to local infiltration of surrounding structures. Differential diagnosis based on imaging includes sarcomas, meningiomas and lipomas. We discuss two contrasting cases presenting with well-circumscribed cystic paraspinal lesions indicative of an infiltrative tumour and discuss the radiological and histological differences that distinguish myxomas from similar tumours. Surgical resection of the tumour was performed in both cases, however one patient required surgical fixation due to bony erosion secondary to tumour infiltration. Immuno-histopathological analysis confirmed the diagnosis of a cellular myxoma. Follow up imaging at 6 months confirmed no symptomatic or tumour recurrence in both cases. Histological analysis is the definitive means for diagnosis to differentiate myxomas from other tumours. Recurrence is rare if full resection is achieved.
肌内黏液瘤是一种罕见的良性间叶组织肿瘤,主要发生于大的骨骼肌,表现为大的、生长缓慢且无痛的肿块。发生于脊柱者罕见,可偶然发现,或因周围结构受局部浸润出现局部症状而得以诊断。基于影像学的鉴别诊断包括肉瘤、脑膜瘤和脂肪瘤。我们讨论两例截然不同的病例,均表现为边界清晰的囊性椎旁病变,提示为浸润性肿瘤,并探讨黏液瘤与相似肿瘤在放射学和组织学上的差异。两例均行肿瘤手术切除,然而其中一例患者因肿瘤浸润继发骨质侵蚀而需要手术固定。免疫组织病理学分析确诊为细胞性黏液瘤。6个月的随访影像学检查证实两例均无任何症状或肿瘤复发。组织学分析是鉴别黏液瘤与其他肿瘤的确诊方法。若实现完整切除,复发罕见。