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Dangore-Khasbage S, Kambala R, Sabban H, Tiwari A, Khubchandani M. Rapidly Expanding Odontogenic Myxoma: An Entity With Diagnostic Challenges-A Case Report. Case Rep Dent 2025; 2025:5741422. [PMID: 40260226 PMCID: PMC12011459 DOI: 10.1155/crid/5741422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Accepted: 03/25/2025] [Indexed: 04/23/2025] Open
Abstract
Odontogenic myxoma is a rare benign odontogenic tumor having locally aggressive behavior. It frequently affects the females in the second or third decade of life and commonly occurs in the mandibular posterior region as a slow-growing lesion. The aggressive behavior is often seen in maxillary lesions. However, this case report describes odontogenic myxoma with aggressive or rapidly expanding behavior occupying the ramus and angle of the mandible in few months. An 18-year-old girl reported with a chief complaint of gradually increasing painless swelling in the posterior region of the mandible for 4 months. Extraoral examination revealed diffuse, firm to hard, nontender swelling on the left mandibular posterior region and intraorally missing mandibular left third molar with expansion in the buccal and lingual aspect in the mandibular posterior region. Radiographic features depicted large well-defined multilocular radiolucency and impacted mandibular left third molar. Based on clinical features and radiographic findings, ameloblastic fibroma, dentigerous cyst, unicystic ameloblastoma, and odontogenic keratocyst were the entities considered in differential diagnosis. However, the histopathological examination confirmed it as odontogenic myxoma which was then treated surgically. This concludes that though radiographic examination is the first step meant for diagnosis, odontogenic myxoma depicts variety of radiographic features mandating histopathological examination for confirmation of the diagnosis.
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Affiliation(s)
- Suwarna Dangore-Khasbage
- Oral Medicine & Radiology, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Higher Education and Research, Deemed to be University, Wardha, Maharashtra, India
| | - Rajanikanth Kambala
- Oral and Maxillofacial Surgery, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Higher Education and Research, Deemed to be University, Wardha, Maharashtra, India
| | - Hanadi Sabban
- Oral Radiology Division, Oral Diagnostic Sciences Department, King Abdulaziz University Faculty of Dentistry, Jeddah, Makkah Province, Saudi Arabia
| | - Aakanksha Tiwari
- Oral Medicine & Radiology, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Higher Education and Research (DU), Wardha, Maharashtra, India
| | - Monika Khubchandani
- Pedodontics, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Higher Education and Research (DU), Wardha, Maharashtra, India
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2
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Quigley C, Tong JY, Farshid G, Bonar F, Selva D. Myxoma: An Unusual Aggressive Orbital Lesion. Ophthalmic Plast Reconstr Surg 2025; 41:e2-e6. [PMID: 39197176 DOI: 10.1097/iop.0000000000002771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2024]
Abstract
Myxoma is a rare tumor that can be challenging to diagnose, with imaging findings that can be nonspecific. We present a case of a 21-year-old man who presented with a subacute history of right visual deterioration and proptosis. Imaging showed a large right superomedial orbital mass of 43 × 31 × 24 mm, which enhanced heterogeneously and was eroding the adjacent orbital roof and medial wall. An excisional biopsy was performed via a lid crease approach under transorbital endoscopic guidance. We review the clinical, radiological, and histological characteristics of myxoma. In addition, we highlight important associations with genetic syndromes including Carney complex and Mazabraud syndrome.
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Affiliation(s)
- Clare Quigley
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Jessica Y Tong
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Gelareh Farshid
- South Australian Pathology, Royal Adelaide Hospital, Adelaide, Australia
| | - Fiona Bonar
- Douglass Hanly Moir Pathology, Macquarie Park, Sydney, Australia
| | - Dinesh Selva
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
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3
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Tilaveridis I, Kalaitsidou I, Karakostas P, Tsavos I, Tilaveridou S, Hliopoulos M, Zarampouka K. Myxoma of the upper lip: a case report and brief review of the literature. J Surg Case Rep 2023; 2023:rjad269. [PMID: 37251249 PMCID: PMC10212666 DOI: 10.1093/jscr/rjad269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 04/25/2023] [Indexed: 05/31/2023] Open
Abstract
Myxomas are rare neoplasms of mesenchymal origin, which consist of many undifferentiated stellate and spindle-shaped cells in abundant loose myxoid stroma with collagen fibers. A 74-year-old patient presented in our oral and maxillofacial department with a slow growing mass within the upper lip. The mass was surgically excised in the toto, followed by a histological and immunohistochemical examination. The findings revealed that it was a myxoma. These tumors are very rare and should be included in the differential diagnosis of damage of the upper lip. As long as the myxoma is properly removed, there is no risk of recurrence.
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Affiliation(s)
- Ioannis Tilaveridis
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioanna Kalaitsidou
- Universitätsklinik für Schädel-, Kiefer- und Gesichtschirurgie, Inselspital, Universitätsspital Bern, Bern, Switzerland
| | - Panagiotis Karakostas
- Correspondence address. Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece. E-mail:
| | - Ioannis Tsavos
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sofia Tilaveridou
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Michael Hliopoulos
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Katerina Zarampouka
- Department of Pathology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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4
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Chauhan K, Manjunatha BS, Mehendiratta M, Lakhanpal M. Oral soft-tissue myxoma. BMJ Case Rep 2023; 16:e251035. [PMID: 36599490 DOI: 10.1136/bcr-2022-251035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Oral soft-tissue myxomas of the oral cavity have been sparsely cited in the medical literature worldwide. This could be due to other clinically and/or histologically similar lesions requiring accurate differential diagnosis by experienced physicians and pathologists. Although myxomas are benign and do not metastasise, they have higher rates of recurrence and deserve proper attention and to be reported as well. Soft-tissue myxomas of the oral cavity are extremely rare and very few cases have been reported in the literature. The article describes a soft-tissue myxoma in a male patient in his 40s and review of published cases.
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Affiliation(s)
- Keerti Chauhan
- Oral and Maxillofacial Pathology, ITS Dental College Hospital and Research Centre, Greater Noida, Uttar Pradesh, India
| | | | - Monica Mehendiratta
- Department of Oral Pathology and Microbiology, ITS Dental College Hospital and Research Centre, Greater Noida, Uttar Pradesh, India
| | - Manisha Lakhanpal
- Oral Medicine and Radiology, ITS Dental College Hospital and Research Centre, Greater Noida, Uttar Pradesh, India
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Young R, Laing B, Best B, Harrison GL, Zwagerman N. Endoscopic endonasal resection of a primary intraosseous clival myxoma: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2022; 4:CASE22334. [PMID: 36317240 PMCID: PMC9624160 DOI: 10.3171/case22334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/29/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND An intraosseous myxoma is a rare, benign mesenchymal tumor that penetrates the bone. The occurrence of an intraosseous myxoma in the clivus is a unique presentation of the disease. OBSERVATIONS The authors discuss the case of a 15-year-old male with a new diagnosis of a primary clival intraosseous myxoma presenting with cranial nerve VI palsy. This is the third documented case of this pathology occurring in the clivus. This patient was successfully treated with endoscopic endonasal resection of the tumor. LESSONS Primary clival intraosseous myxomas are extremely rare, but nonetheless it is important to add it to the differential diagnosis of clival masses. This mass has a high risk of recurrence, and prior literature suggests gross total resection may improve chances of progression-free survival. However, further larger studies are needed to provide guidelines regarding proper management of this pathology.
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Affiliation(s)
- Riley Young
- Medical College of Wisconsin School of Medicine, Milwaukee, Wisconsin; and
| | - Brandon Laing
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Benjamin Best
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Gillian L. Harrison
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Nathan Zwagerman
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
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Vidales-Miranda R, Fiori-Chíncaro GA, Agudelo-Botero AM, Llaguno-Rubio JM. [Use of current imaging tools for the study of odontogenic myxoma. A review of the literature]. REVISTA CIENTÍFICA ODONTOLÓGICA 2022; 10:e107. [PMID: 38389660 PMCID: PMC10880719 DOI: 10.21142/2523-2754-1002-2022-107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 03/08/2022] [Indexed: 02/24/2024] Open
Abstract
Odontogenic myxoma (OM) is currently classified as a benign tumor of ectomesenchymal origin, observed between the second and fourth decade of age, with a predilection in women and predominance in the mandibular region, composed of rounded and angular cells embedded in an abundant myxoid stroma, of aggressive biological behavior, having the characteristic of being locally infiltrative. Tumor cells spread in the intratrabecular space beyond the bone limit, making it difficult to determine the edge of the tumor, even without cortical continuity, presenting intermittent direct contact with soft tissue; the appearance can be unilocular (small lesions), or commonly the typical image is that of a destructive lesion with poorly defined borders with a multilocular growth pattern, for which the use of advanced medical images such as Cone Beam Computed Tomography (CTHC), Computed Tomography (CT), Magnetic Resonance Imaging (MRI), are useful to establish an adequate diagnosis with the ability to point out the characteristics of OM with precision and three-dimensional perspective. This review presents a systematic analysis of the types of imaging tools currently used for the study of OM.
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Affiliation(s)
- Rocío Vidales-Miranda
- Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca. Sucre, Bolivia. Universidad Mayor de San Francisco Xavier Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca Sucre Bolivia
| | - Gustavo Adolfo Fiori-Chíncaro
- División de Radiología Bucal y Maxilofacial de la Universidad Científica del Sur. Lima, Perú. , Universidad Científica del Sur División de Radiología Bucal y Maxilofacial Universidad Científica del Sur Lima Peru
| | - Ana María Agudelo-Botero
- Universidad Autónoma de Manizales. Manizales, Colombia. Universidad Autónoma de Manizales Universidad Autónoma de Manizales Manizales Colombia
| | - Jhoana Mercedes Llaguno-Rubio
- División de Radiología Bucal y Maxilofacial de la Universidad Científica del Sur. Lima, Perú. , Universidad Científica del Sur División de Radiología Bucal y Maxilofacial Universidad Científica del Sur Lima Peru
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A Case of Myxoma Arising in the Buccal Mucosa. Case Rep Dent 2021; 2021:1358481. [PMID: 34434584 PMCID: PMC8382542 DOI: 10.1155/2021/1358481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 08/06/2021] [Indexed: 11/17/2022] Open
Abstract
Myxomas arising in the oral and maxillofacial areas are extremely rare. This study reports a case of myxoma arising in the soft tissue beneath the buccal mucosa of an 86-year-old man.
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Yu TT, Yu H, Cui Y, Liu W, Cui XY, Wang X. Laryngeal myxoma: A case report. World J Clin Cases 2021; 9:2823-2829. [PMID: 33969065 PMCID: PMC8058668 DOI: 10.12998/wjcc.v9.i12.2823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/12/2021] [Accepted: 02/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Myxomas are benign tumors of mesenchymal origin that rarely occur in the larynx.
CASE SUMMARY We report a case of a laryngeal myxoma that presented as a right vocal cord mass in a 54-year-old man.
CONCLUSION Laryngeal myxoma is a rare benign tumor in the larynx. It is difficult to distinguish glottis myxoma from vocal cord polyps on laryngoscopy. We recommend that otolaryngologists acquire a better understanding of this disease. If a laryngeal myxoma is suspected, dynamic laryngoscopy, acoustic voice analysis, and pathological biopsy should be performed.
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Affiliation(s)
- Ting-Ting Yu
- Department of Otolaryngology, Head and Neck Surgery, Jilin University, Changchun 130000, Jilin Province, China
| | - Hong Yu
- Department of Otolaryngology, Head and Neck Surgery, Jilin University, Changchun 130000, Jilin Province, China
| | - Yu Cui
- Department of Otolaryngology, Head and Neck Surgery, Jilin University, Changchun 130000, Jilin Province, China
| | - Wei Liu
- First Operation Room, Jilin University, Changchun 130000, Jilin Province, China
| | - Xiang-Yan Cui
- Department of Otolaryngology, Head and Neck Surgery, Jilin University, Changchun 130000, Jilin Province, China
| | - Xin Wang
- Department of Otolaryngology, Head and Neck Surgery, Jilin University, Changchun 130000, Jilin Province, China
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9
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Ng C, Mentias Y, Abdelgalil A. Imaging features of non-epithelial tumours of the larynx. Clin Radiol 2020; 75:711.e5-711.e12. [DOI: 10.1016/j.crad.2020.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 01/23/2020] [Indexed: 12/27/2022]
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11
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Mbadugha TN, Kanaya K, Horiuchi T, Iwaya M, Ohaegbulam SC, Hongo K. Primary myxoid temporal bone tumor: A rare neurosurgical manifestation of Carney complex? Surg Neurol Int 2020; 11:166. [PMID: 32637219 PMCID: PMC7332703 DOI: 10.25259/sni_170_2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/09/2020] [Indexed: 02/04/2023] Open
Abstract
Background: Carney complex (CNC) is a rare autosomal dominant syndrome, manifesting mainly with cardiac, cutaneous, and mucosal myxomas. Osteochondromyxoma is known as an extremely rare bone lesion of CNC which usually appears early in life; however, there were no reports of primary bone myxoma of the skull in the patients with CNC. We present the first case of primary myxoid skull tumor in the patient with CNC. Case Description: We report the left temporal bone tumor with significant intracranial mass effect in a 58-year- old woman already diagnosed with CNC. Complete resection of the tumor with skull bone reconstruction was carried out. Pathological diagnosis was labeled the lesion as an atypical myxoid spindle cell neoplasm. The features were different from atrial myxoma and osteochondromyxoma which has been described in CNC. There have been no signs of recurrence in 9 years follow-up. Conclusion: To the best of our knowledge, there have been no reports of the primary myxoid tumors in the skull in the patients with CNC. This paper highlighted a possible important association between CNC and primary intracranial myxoid tumors.
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Affiliation(s)
- Tobechi Nwankwo Mbadugha
- Department of Neurosurgery, Memfys Hospital for Neurosurgery, Onitsha Expressway, Enugu, Nigeria
| | - Kohei Kanaya
- Department of Neurosurgery, Shinshu University School of Medicine, Asahi, Matsumoto, Nagano, Japan
| | - Tetsuyoshi Horiuchi
- Department of Neurosurgery, Shinshu University School of Medicine, Asahi, Matsumoto, Nagano, Japan
| | - Mai Iwaya
- Department of Laboratory Medicine, Shinshu University School of Medicine, Asahi, Matsumoto, Nagano, Japan
| | | | - Kazuhiro Hongo
- Department of Neurosurgery, Shinshu University School of Medicine, Asahi, Matsumoto, Nagano, Japan
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12
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Hasnaoui M, Masmoudi M, Belaid T, Mighri K. Isolated Myxoma of the External Auditory Canal: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2020; 100:991S-994S. [PMID: 32525735 DOI: 10.1177/0145561320927913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Myxoma is a benign myxoid tumor of connective tissue that develops primarily in the heart. At the level of the external auditory canal, it is extremely rare. It can be isolated or associated with Carney syndrome. Only 5 cases of isolated myxoma of the external auditory canal have been reported in the literature. We present the case of a 53-year-old patient who consulted for a hearing loss that has been evolving for 3 years. Otoscopy revealed a mass filling the external auditory canal. The scan showed a total filling of the external auditory canal with a homogenous sessile neoformation of 20 × 10 mm. This mass was completely resected and the histological examination showed spindle-shaped and star-shaped cells against an abundant myxoid background, which was consistent with myxoma. All the tests, done to eliminate Carney syndrome, did not reveal any abnormalities. The postoperative course was favorable, and no complications were noted. The patient was under follow-up. There was no recurrence 1 year after surgery.
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Affiliation(s)
- Mehdi Hasnaoui
- Department of Otolaryngology-Head and Neck Surgery, Tahar Sfar Hospital, Mahdia, Tunisia
| | - Mohamed Masmoudi
- Department of Otolaryngology-Head and Neck Surgery, Tahar Sfar Hospital, Mahdia, Tunisia
| | - Takwa Belaid
- Department of Otolaryngology-Head and Neck Surgery, Tahar Sfar Hospital, Mahdia, Tunisia
| | - Khalifa Mighri
- Department of Otolaryngology-Head and Neck Surgery, Tahar Sfar Hospital, Mahdia, Tunisia
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Weisbrod L, Smith K, Camarata P, Alvarado A, Andrews B. Orbital myxoma: A case report. Surg Neurol Int 2020; 11:43. [PMID: 32257569 PMCID: PMC7110406 DOI: 10.25259/sni_323_2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 02/22/2020] [Indexed: 11/14/2022] Open
Abstract
Background: Myxomas are rare, locally infiltrative, benign neoplasms of mesenchymal origin. Although benign, these tumors are locally aggressive with a high rate of recurrence following conservative resection. Their relative infrequency, variable location, and insidious growth present a diagnostic challenge to clinicians. Cases of myxomas have been described throughout the body, but intraosseous myxomas of the orbit are exceedingly rare. Case Description: We report a case of a 53-year-old male with a history of chronic sinusitis and symptoms of hyposmia and bifrontal headaches refractory medical management who presented for neurosurgical evaluation after radiographic findings of an orbital lesion. Physical examination was unremarkable with intact extraocular movements. Prior radiographic workup demonstrated a 2.4 × 2.7 × 2.2 cm expansile lesion involving the bony left superior and lateral orbit. A prior open biopsy was performed which demonstrated a low-grade spindle cell neoplasm consistent with intraosseous myxoma. Definitive resection was recommended through the left orbitozygomatic craniotomy. The patient tolerated the procedure well without complications. Gross total resection was achieved. Reconstruction of the orbital roof and lateral orbital wall was performed with a frontal bone autograft and titanium plating. Postoperative course was uneventful, and the patient was discharged home postoperative day 2. At 1-month follow-up visit, the patient remained neurologically intact. Surveillance imaging at 6 months and 1 year remained stable without signs of recurrence. Conclusion: Intraosseous orbital myxomas are exceedingly rare entities. Although they are considered benign neoplasms, myxomas demonstrate high recurrence rates. The authors report a unique case of an orbital myxoma that was successfully treated through an orbitozygomatic approach achieving gross total resection.
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Affiliation(s)
- Luke Weisbrod
- Department of Neurosurgery, University of Kansas Health System, Kansas City, Kansas
| | - Kyle Smith
- Department of Neurological Surgery, University of Kansas Medical Center, Kansas City, Kansas
| | - Paul Camarata
- Department of Neurosurgery, University of Kansas Health System, Kansas City, Kansas
| | - Anthony Alvarado
- Department of Neurosurgery, University of Kansas Health System, Kansas City, Kansas
| | - Brian Andrews
- Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kansas
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14
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Weng JC, Song LR, Li D, Wang L, Wu Z, Wang JM, Li GL, Jia W, Zhang LW, Zhang JT. Surgical management and prognostic factors for primary intracranial myxoma: a single-institute experience with a systematic review. J Neurosurg 2019; 131:1115-1125. [PMID: 30544354 DOI: 10.3171/2018.6.jns181132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 06/20/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Primary intracranial myxomas (PICMs) are extremely rare neoplasms, and their management and prognostic factors remain ambiguous. The authors aimed to elaborate the radiological features, evaluate the risk factors for progression-free survival (PFS), and propose a treatment protocol based on pooled data from cases treated at their institute and those found in the literature. METHODS Clinical data from all cases of PICMs treated at the authors' institute and those cases reported in the English-language literature between 1987 and December 2017 were reviewed. The authors searched the Ovid MEDLINE, Embase, PubMed, and Cochrane databases using the keywords "myxoma" and "central nervous system," "intracranial," "cerebral," "skull base," "skull," or "brain." Previously published data were processed and used according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk factors in the pooled cohort were evaluated. RESULTS Cases from the authors' institute included 21 males and 9 females, with a mean age of 35.7 ± 1.7 years. Gross-total resection (GTR) and non-GTR were achieved in 6 (20.0%) and 24 (80.0%) patients, respectively. After a mean follow-up of 86.7 ± 14.1 months, recurrence occurred in 6 (24%) patients, for a median PFS time of 85.2 months (range 36.0-136.0 months) and no deaths. In the literature between 1987 and 2017, 35 cases of PICM were identified in 14 males and 21 females with a mean age of 31.7 ± 3.2 years. GTR and non-GTR were achieved in 23 (65.7%) and 9 (25.7%) cases, respectively. After a mean follow-up of 25.8 ± 6.9 months (range 1.0-156.0 months), recurrence occurred in 4 (14.3%) patients, for a median PFS time of 11.0 months (range 3.0-36.0 months) and no deaths. Actuarial PFS rates at 1, 5, and 10 years were 93.0%, 80.6%, and 67.9%, respectively. A multivariate model demonstrated that GTR (HR 0.058, 95% CI 0.005-0.680, p = 0.023) was the only factor that favored PFS. CONCLUSIONS PICMs are rare neoplasms with a slightly higher occurrence in males. GTR was the only favorable factor for PFS. Based on statistical results, GTR alone, if tolerable, is advocated as the optimal treatment for PICM. Nevertheless, conservative excision may be preferred to avoid damage to vital structures. PICMs have a tendency to recur within a few years of the initial surgery if resection is incomplete; therefore, close postoperative follow-up is mandatory. Future studies with larger cohorts are necessary to verify the study findings.Systematic review registration no.: CRD42018091517 (www.crd.york.ac.uk/prospero/).
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Affiliation(s)
- Jian-Cong Weng
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University; and
| | - Lai-Rong Song
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University; and
| | - Da Li
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University; and
| | - Liang Wang
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University; and
| | - Zhen Wu
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University; and
| | - Jun-Mei Wang
- 2Department of Neuropathology, Beijing Neurosurgical Institute, Beijing, People's Republic of China
| | - Gui-Lin Li
- 2Department of Neuropathology, Beijing Neurosurgical Institute, Beijing, People's Republic of China
| | - Wang Jia
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University; and
| | - Li-Wei Zhang
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University; and
| | - Jun-Ting Zhang
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University; and
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15
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Kim SM, Kim CK, Kim SH, Lee MC, Kim JN, Choi HG, Shin DH, Jo DI. Myxoma arising from the parotid gland. Arch Craniofac Surg 2019; 20:186-190. [PMID: 31256556 PMCID: PMC6615422 DOI: 10.7181/acfs.2019.00122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/04/2019] [Accepted: 04/22/2019] [Indexed: 12/29/2022] Open
Abstract
Myxomas can be divided into two groups: those derived from the facial skeleton, and those derived from external skeletal soft tissue. Soft tissue myxomas of the head and neck are uncommon, with fewer than 50 cases reported. In any form and location, myxoma of parotid gland is rare. We report a case of myxoma arising from the left superficial lobe of the parotid gland with good longterm follow-up after superficial parotidectomy with tumor excision. A 49-year-old man was referred to our department of plastic and reconstructive surgery with a painless palpable mass that had persisted in the left mandible angle region for 2 years. Excision of the facial mass and superficial parotidectomy with facial nerve preservation were performed. The biopsy result was myxoma. Long-term follow-up for 22 months showed favorable results without evidence of recurrence but with temporary facial nerve weakness right after the surgery. Myxoma should be considered as a differential diagnosis when benign tumor of the parotid gland is being considered.
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Affiliation(s)
- Seung Min Kim
- Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
| | - Cheol Keun Kim
- Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
| | - Soon Heum Kim
- Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
| | - Myung Chul Lee
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Jee Nam Kim
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Hyun Gon Choi
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Dong Hyeok Shin
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Dong In Jo
- Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
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Wei X, Chang T, Shen H. Radiologic Features of Primary Intracranial Myxomas from the Skull Base: 14 Case Reports and Literature Review. World Neurosurg 2019; 126:e77-e83. [PMID: 30738938 DOI: 10.1016/j.wneu.2019.01.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 01/16/2019] [Accepted: 01/19/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Primary intracranial myxomas (PIMs) are extremely rare benign tumors that arise from the skull base. The aim of this study was to characterize the radiologic manifestation of PIMs in a series of 14 cases. METHODS We reviewed the imaging and clinical data of 14 patients with pathologically proven PIMs. Assessed features of lesions include shape, margin, bony destruction, attenuation and/or signal intensity, and pattern of enhancement. RESULTS Extremely high-density foci indicating calcification or bony debris within the tumors were observed in 5 cases on computed tomography images. On magnetic resonance images, the tumors demonstrated heterogeneous hypointensity on T1-weighted images (T1WI) and hyperintensity on T2-weighted images (T2WI). A honeycomb pattern on enhanced T1WIs was observed in 63.6% (7/11) of the cases. CONCLUSIONS Radiologic findings of PIMs include calcified foci or bone debris on computed tomography, heterogeneous hypointensity on T1WI and predominantly hyperintensity on T2WI, and honeycomb appearance on enhanced T1WI.
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Affiliation(s)
- Xinhua Wei
- Department of Radiology, Guangzhou First hospital, Second Affiliated Hospital, South China University of Technology, Guangzhou, Guangdong, China
| | - Tianjing Chang
- Department of Neuroradiology, Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huicong Shen
- Department of Neuroradiology, Tiantan Hospital, Capital Medical University, Beijing, China.
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17
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Mascitti M, Togni L, Pirani F, Rubini C, Santarelli A. Peripheral Odontogenic Myxoma: Report of Two New Cases with a Critical Review of the Literature. Open Dent J 2018. [DOI: 10.2174/1874210601812011079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
Odontogenic myxoma is a benign mesenchymal odontogenic tumor that is more frequently found in the mandibular molar region. The extra-osseous counterpart, called Peripheral Odontogenic Myxoma (POM), is an exceedingly rare entity and with very low aggressive potential.
Methods:
Clinical and radiographic findings are not specific, and difficulties may exist in differentiating histological findings of POM from other tumors with myxoid features, such as fibromas and oral focal mucinosis. Due to the fact that the presence of odontogenic epithelium is not required for the diagnosis, a myxoid lesion without odontogenic nests that develops in extraosseous position can be misdiagnosed with a soft tissue myxoma.
Case Reports:
We thereby present two cases of POM and conduct an extensive and critical review of the English literature, taking into consideration both certain and putative cases of POM.
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Head and Neck Myxoma Presenting as Isolated Laryngeal Polyp. Case Rep Otolaryngol 2018; 2018:6868737. [PMID: 29984026 PMCID: PMC6015694 DOI: 10.1155/2018/6868737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/15/2018] [Accepted: 05/20/2018] [Indexed: 11/25/2022] Open
Abstract
Myxoma is a benign tumour with a propensity for local infiltration and recurrence. Laryngeal myxoma presents as a submucosal polyp. Being an uncommon tumour and mimicking vocal cord polyp, only anecdotal evidence is available in the literature. The literature was reviewed from 1986 onwards using the keywords “myxoma” and “larynx.” The databases used were PubMed, Google Scholar, Scopus, and Web of Science. Along with this, we also report our case of vocal fold myxoma. We found a total of 19 studies reporting laryngeal myxoma. Laryngeal myxoma typically affects males in the 6th decade with a history of smoking. Unlike myxomas originating outside the larynx, recurrence is not widely described, and microlaryngeal surgery will usually suffice. Laryngeal myxomas should definitely be kept in the list of differential diagnosis when dealing with a benign-looking vocal fold lesion.
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19
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The Unusual Presentation of a Myxoma Within the Sphenoid Sinus: Case Report and Review of the Literature. World Neurosurg 2017; 103:951.e5-951.e12. [PMID: 28433840 DOI: 10.1016/j.wneu.2017.04.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 04/02/2017] [Accepted: 04/05/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND We describe a rare case of a sphenoid sinus myxoma that was resected via an endoscopic endonasal skull base approach. We review the literature regarding these rare tumors of the paranasal sinuses. CASE DESCRIPTION A 72-year-old woman was diagnosed with an incidental sphenoid sinus tumor and left sphenoid wing meningioma during a workup for left-sided proptosis and diplopia. Biopsies of the sphenoid wing and sphenoid sinus tumors were obtained. After undergoing surgical resection of the meningioma, the patient then underwent definitive resection of the sphenoid sinus myxoma via endoscopic endonasal skull base approach. Postoperative imaging demonstrated a gross total resection. The patient suffered postoperative thromboembolic complications due to underlying hypercoagulable state but made a complete recovery and returned to her neurologic baseline. There has been no evidence of recurrent myxoma in the sphenoid sinus 24 months after surgery. DISCUSSION Myxomas are benign tumors derived from primitive mesenchyme. Myxomas very rarely present in the paranasal or skull base location. Complete surgical resection is the primary treatment for these tumors. The endoscopic endonasal approach is an effective technique for resecting various benign and more aggressive extradural skull base tumors. CONCLUSIONS Myxomas of the sphenoid sinus are rare. The endoscopic endonasal skull base approach is an effective and minimal access technique for resection of this rare tumor of the sphenoid sinus.
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20
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Lee DJ, Chung YJ. A Case of Fibromyxoma of the Maxilla. JOURNAL OF RHINOLOGY 2017. [DOI: 10.18787/jr.2017.24.1.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Dong-Jun Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
| | - Young-Jun Chung
- Department of Otorhinolaryngology-Head & Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
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21
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Satyarthee GD, Moscote-Salazar LR. Primary giant myxoma of the temporal bone with major intracranial extension: presenting with hearing impairment and ear polyp. ROMANIAN NEUROSURGERY 2016. [DOI: 10.1515/romneu-2016-0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Myxomas are mesenchymal origin, benign tumor, constituting approximately half of the benign cardiac tumors. Occasionally, it may also occurs at other locations, though the intracranial location of a myxoma is considered exceptionally rare. Only isolated few cases of intracranial myxoma are reported in the literature, almost all were locally confined within the originating bone. The extensive Pubmed and Medline search yielded only eight cases of primary myxoma arising in the temporal bone with extension into intracranial compartment. However intracranial extension is limited as early detection, however, Osterdock et al reported a case also arising from temporal bone with extensive intracranial extension. Author report an interesting case of intracranial myxoma in 27- year- old- male, involving the temporal bone associated with extensive bony erosion and also extending into infratemporal fossa, mastoid, and frontoparietal region and a polypoidal mass protruding into external ear. To the best of knowledge of authors, temporal myxoma presenting with external ear polypoidal mass, which underwent successful surgical excision is not reported and represent first case in the world literature.
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22
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Connor MP, Neilson M, Schmalbach CE. Maxillary myxoma: A case report and review. EAR, NOSE & THROAT JOURNAL 2016; 94:E1-3. [PMID: 26053984 DOI: 10.1177/014556131509400613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
An odontogenic myxoma is a rare, benign tumor that is found almost exclusively in the facial bones, usually the mandible. The diagnosis poses a challenge because its features overlap with those of other benign and malignant neoplasms. We present an unusual case of odontogenic myxoma that involved the maxilla, and we review the clinical, radiographic, and histologic characteristics of this case. Even though it is benign, odontogenic myxoma can be locally invasive and cause significant morbidity. Complete surgical excision is the treatment of choice, but it can be challenging because of the tumor's indistinct margins.
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Affiliation(s)
- Matthew P Connor
- Department of Otolaryngology, Wilford Hall Medical Center, Lackland AFB, TX, USA
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23
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Al-Qahtani K, Islam T, AlOulah M, Bafaqeeh S, Faqeeh Y. Myxoma of the nasal bone. Auris Nasus Larynx 2016; 44:340-344. [PMID: 27328895 DOI: 10.1016/j.anl.2016.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 05/04/2016] [Accepted: 05/13/2016] [Indexed: 11/17/2022]
Abstract
Myxoma is a benign tumor that arises from mesenchymal tissue, and found in the soft tissue and less commonly in the bone. The majority of bony myxomas of the head and neck occur in the jaws and maxilla. We report an extremely rare case of nasal bone myxoma in a 52-year-old man. The diagnosis was confirmed by biopsy. Due to the aggressive nature of the lesion the nasal bone was eroded by the disease. The patient underwent resection of the mass with reconstruction of the defect by septal cartilage. The patient remains tumor free after 5 years.
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Affiliation(s)
- Khalid Al-Qahtani
- Department of Otolaryngology-Head & Neck Surgery, King Abdulaziz University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Tahera Islam
- College of Medicine and Research Center, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad AlOulah
- Department of Otolaryngology-Head & Neck Surgery, King Abdulaziz University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Sameer Bafaqeeh
- Department of Otolaryngology-Head & Neck Surgery, King Abdulaziz University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Yasser Faqeeh
- Department of Opthalmology, King Abdulaziz University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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24
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Ryu JI, Cheong JH, Kim JM, Kim CH. A Primary Ossifying Intracranial Myxoma Arising from the Ethmoid Sinus. J Korean Neurosurg Soc 2015; 58:281-5. [PMID: 26539274 PMCID: PMC4630362 DOI: 10.3340/jkns.2015.58.3.281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 01/30/2015] [Accepted: 02/02/2015] [Indexed: 11/27/2022] Open
Abstract
Myxomas are rare benign tumors that originate from mesenchymal tissue. They usually develop in the atrium of the heart, the skin, subcutaneous tissue, or bone. Involvement of the skull base with an intracranial extension is very rare and not well-described in the literature. We report a rare case of primary intracranial ossifying myxoma arising from the anterior skull base and mimicking a huge chondrosarcoma, and we review the relevant literature.
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Affiliation(s)
- Je Il Ryu
- Department of Neurosurgery, Hanyang University Guri Hospital, Guri, Korea
| | - Jin Hwan Cheong
- Department of Neurosurgery, Hanyang University Guri Hospital, Guri, Korea
| | - Jae Min Kim
- Department of Neurosurgery, Hanyang University Guri Hospital, Guri, Korea
| | - Choong Hyun Kim
- Department of Neurosurgery, Hanyang University Guri Hospital, Guri, Korea
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25
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Tataryn Z, Tracy J, Tsang C, Wu J, Heilman CB, Wein RO. Intramuscular myxoma of the cervical paraspinal musculature: case report and review of the literature. Am J Otolaryngol 2015; 36:273-6. [PMID: 25481300 DOI: 10.1016/j.amjoto.2014.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 10/05/2014] [Indexed: 11/15/2022]
Abstract
CASE A 57year old female patient presented with a painful right-sided neck mass that on MRI was shown to be adherent to the posterior aspect of the sternocleidomastoid muscle. The mass was surgically resected en bloc without complications. Histopathologic analysis revealed the mass to be a myxoma. REVIEW To date, there have been several case reports of myxomas, although very few involving the head or neck. The majority of the literature available concurs that myxomas are benign neoplasms that exhibit characteristic qualities on MRI imaging. The definitive treatment by consensus is surgical excision. CONCLUSIONS Although the incidence of head and neck myxomas is low, it is important to include in the differential of a neck mass with certain radiographic findings.
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Affiliation(s)
- Zac Tataryn
- Department of Neurosurgery, Tufts Medical Center, Boston, MA
| | - Jeremiah Tracy
- Department of Otolaryngology - Head & Neck Surgery, Tufts Medical Center, Boston, MA
| | - Christopher Tsang
- Department of Otolaryngology - Head & Neck Surgery, Tufts Medical Center, Boston, MA.
| | - Julian Wu
- Department of Neurosurgery, Tufts Medical Center, Boston, MA
| | - Carl B Heilman
- Department of Neurosurgery, Tufts Medical Center, Boston, MA
| | - Richard O Wein
- Department of Otolaryngology - Head & Neck Surgery, Tufts Medical Center, Boston, MA
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26
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Guo YJ, Li G, Gao Y, Ma XC. An unusual odontogenic myxoma in mandible and submandibular region: a rare case report. Dentomaxillofac Radiol 2014; 43:20140087. [PMID: 25270061 DOI: 10.1259/dmfr.20140087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
An otherwise healthy 14-year-old male was referred to our hospital for the evaluation of a mass that was noticed 2 months previously. The mass was located in the left submandibular area. Comprehensive imaging examinations including panoramic radiography, CT and positron emission tomography-CT were performed. Appropriate surgical management and histopathological examination were taken for the patient. Histopathological examination demonstrated an odontogenic myxoma.
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Affiliation(s)
- Y-J Guo
- 1 Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, China
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27
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Shadfar S, Scanga L, Dodd L, Buchman CA. Isolated myxoma of the external auditory canal. Laryngoscope 2014; 124:1220-2. [PMID: 24114812 DOI: 10.1002/lary.24392] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/31/2013] [Accepted: 07/31/2013] [Indexed: 11/10/2022]
Abstract
The majority of neoplasms within the external auditory canal are benign. Management of these primary tumors and their local recurrences are discussed herein. We present a case of an isolated myxoma of the external auditory canal with a review of the common histopathological and radiographic features. Although rare, this highlights the possibility of encountering benign tumor types that carry associated morbidity or mortality due to manifestations outside of the head and neck.
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Affiliation(s)
- Scott Shadfar
- Department of Otolaryngology Head and Neck Surgery (S.S., C.A.B.), University of North Carolina Hospitals, Chapel Hill, North Carolina, U.S.A
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28
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Ritchie A, Youngerman J, Fantasia JE, Kahn LB, Cocker RS. Laryngeal myxoma: a case report and review of the literature. Head Neck Pathol 2013; 8:204-8. [PMID: 23975415 PMCID: PMC4022936 DOI: 10.1007/s12105-013-0485-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 08/13/2013] [Indexed: 02/07/2023]
Abstract
Myxomas are a rare benign neoplasm of uncertain mesenchymal cell origin, typically involving the heart. Laryngeal myxomas are uncommon, and are usually misdiagnosed as laryngeal polyp. To the best of our knowledge, there are only nine reported cases in the English literature. We report a case of a laryngeal myxoma presenting clinically as a left vocal cord polyp in a 77 year old male, and review the literature related to this rare entity.
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Affiliation(s)
- Angela Ritchie
- Division of Oral and Maxillofacial Pathology, Department of Dental Medicine, Hofstra North Shore-LIJ School of Medicine, 270-05 76th Avenue, New Hyde Park, NY 11040 USA
| | - Jay Youngerman
- Department of Otolaryngology, Planview Hospital, 888 Old Country Rd, Plainview, NY 11803 USA
| | - John E. Fantasia
- Division of Oral and Maxillofacial Pathology, Department of Dental Medicine, Hofstra North Shore-LIJ School of Medicine, 270-05 76th Avenue, New Hyde Park, NY 11040 USA
| | - Leonard B. Kahn
- Department of Pathology, Hofstra North Shore-LIJ School of Medicine, 900 Fulton Avenue, Hempstead, NY 11550 USA
| | - Rubina S. Cocker
- Department of Pathology, Hofstra North Shore-LIJ School of Medicine, 900 Fulton Avenue, Hempstead, NY 11550 USA ,6 Ohio Drive Room 25, New Hyde Park, NY 11042 USA
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29
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Klimo P, Jha T, Choudhri AF, Joyner R, Michael LM. Fibromyxoma of the lateral skull base in a child: case report. J Neurol Surg Rep 2013; 74:105-10. [PMID: 24303345 PMCID: PMC3836972 DOI: 10.1055/s-0033-1351115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 06/14/2013] [Indexed: 10/29/2022] Open
Abstract
Purpose Fibromyxomas and myxomas are benign tumors of mesenchymal origin usually found outside the nervous system, most commonly in the atrium of the heart. They can also arise in the mandible or maxilla, but it is exceedingly rare to find them within the skull base. The history, histologic features, and the literature, with emphasis on other pediatric cases, are reviewed for this uncommon skull base neoplasm. Methods We describe the case of a 13-year-old girl who presented with a 1-year history of facial weakness, numbness, and hearing loss. A large locally destructive tumor centered in the petrous bone was found on magnetic resonance imaging. Results A mastoidectomy combined with a middle fossa craniotomy was performed for gross total resection. The child is disease free 12 months after surgery. Conclusion Diagnosis could not be made solely on radiographic studies because of the lack of pathognomonic imaging features. Radical resection provided the patient the best chance of cure. Long-term surveillance is necessary to monitor for tumor recurrence.
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Affiliation(s)
- Paul Klimo
- Murphey Neurologic & Spine Institute, Semmes, Memphis, Tennessee, United States ; Le Bonheur Children's Hospital, Memphis, Tennessee, United States ; Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States ; St. Jude Children's Research Hospital, Memphis, Tennessee, United States
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30
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Presentation of Intramuscular Myxoma as an Unusual Neck Lump. J Oral Maxillofac Surg 2013; 71:e210-4. [DOI: 10.1016/j.joms.2012.10.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 10/21/2012] [Accepted: 10/25/2012] [Indexed: 11/20/2022]
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31
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Abstract
Myxomas of bone in the head and neck are rare tumors. We present a 68 year old female with pain and epistaxis who was found to have the first reported case of a myxoma arising within the vomer bone. Some atypical magnetic resonance imaging features are described, however, myxoma imaging features are often non-specific and typically evoke a benign differential diagnosis. Surgical excision is the treatment of choice.
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Affiliation(s)
- David Besachio
- Department of Radiology, Neuroradiology Division, 30 N 1900 E, Salt Lake City, UT 84132, USA.
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32
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Guha-Thakurta N, Deavers M, DeMonte F, Gidley PW. The natural history of primary temporal bone myxoma. Ann Diagn Pathol 2012; 16:280-3. [PMID: 22483549 DOI: 10.1016/j.anndiagpath.2011.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 12/16/2011] [Indexed: 02/03/2023]
Abstract
Primary myxomas of the temporal bone are rare tumors. If misdiagnosed, they can grow into locally aggressive expansile masses resulting in hearing loss, facial paralysis, dural invasion, and mass effect on the adjacent brain parenchyma. This case demonstrates the natural history of an extraordinarily rare tumor over a longer period not previously described. The importance of correlating histopathologic findings with diagnostic imaging features to enable an accurate diagnosis is also emphasized.
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Abstract
Odontogenic myxomas are benign but locally aggressive neoplasms found almost exclusively in the jaws and arise only occasionally in other bones. We present a rare case of odontogenic myxoma occurring in the mandible of a 19-year-old male patient with a brief review of clinical and radiological features, and diagnostic and operative dilemmas in managing the same.
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Abstract
Myxomas are locally invasive, benign mesenchymal neoplasms with odontogenic, osteogenic, or soft tissue origin. Facial myxomas probably account for less than 0.5% of all paranasal sinus and nasal tumors. We report a case of a left painless periocular mass in a 11-month-old girl. The lesion was resected with a clinical diagnosis of lacrimal sac tumor. Histopathology and immunohistochemistry proved the tumor to be a myxoma. There has been no recurrence after 4 years of followup. Midfacial myxomas should be differentiated from other benign and malignant tumors such as dermoid, hamartoma, neurofibroma, nasolacrimal duct cyst, and sarcomas in particular embryonal rhabdomyosarcoma. Because of the infiltrative nature of these tumors, a wide surgery is required to achieve clear resection margins and avoid recurrence.
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35
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Yılmaz S, Edizer DT, Yağız C, Sar M, Cansız H. Maxillary sinus nonodontogenic myxoma extending into the sphenoid sinus and pterygopalatine fossa: case report. EAR, NOSE & THROAT JOURNAL 2012; 90:E28-30. [PMID: 21938690 DOI: 10.1177/014556131109000922] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Myxomas are benign mesenchymal tumors of uncertain etiology. They can arise from odontogenic tissue, as well as from the sinonasal tract and from the facial and temporal bones, apparently from nonodontogenic mesenchyme. Although histologically benign, myxomas are locally invasive. Histopathology demonstrates a characteristically hypocellular lesion with loose stellate cells. We describe the case of a 48-year-old woman with a nonodontogenic maxillary sinus myxoma that invaded the sphenoid sinus and pterygopalatine fossa. We removed the mass via a combined endoscopic and gingivobuccal approach. The rarity of a nonodontogenic sinonasal myxoma extending into the sphenoid sinus and pterygopalatine fossa is the basis for our presentation of this case.
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Affiliation(s)
- Süleyman Yılmaz
- Department of Otorhinolaryngology, Düzce University Faculty of Medicine, Düzce Universitesi, Düzce Tıp Fak KBB ABD, Düzce, Turkey.
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36
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White JR, Weiss S, Anderson D, Mason SE, Schexnaildre MA, Nuss DW, Walvekar RR. Transoral resection of a retropharyngeal myxoma: a case report. SKULL BASE REPORTS 2011; 1:139-44. [PMID: 23984217 PMCID: PMC3743605 DOI: 10.1055/s-0031-1287685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 06/17/2011] [Indexed: 11/30/2022]
Abstract
This study was conducted to describe a retropharyngeal myxoma and discuss clinical concerns regarding this pathology and a retropharyngeal site of occurrence. We present a case report and review of literature. A 71-year-old woman presented with mild right neck pressure for 3 weeks. Imaging studies and head neck examination confirmed a 5.3 × 3.1 × 1.0 cm retropharyngeal mass with no communication to the vertebral column but was intimately involved with the pharyngeal mucosa. A transoral fine needle aspiration biopsy suggested a possible spindle cell neoplasm. A presurgical swallowing consultation was obtained. A transoral excision of the tumor was possible with no intraoperative complications. Histopathology was a cellular myxoma. Postoperative dysphagia required swallowing therapy and nasogastric tube feeding for 2 weeks before oral intake was possible. The patient has no evidence of clinical or radiological recurrence more than 1 year after surgical intervention. We present the second case of a myxoma in the retropharynx reported in English literature. Transoral excision was safe, feasible, and cosmetically appealing option in our patient. Additional clinical data are required to valid its safety and utility as an approach to tumors in the retropharynx. Postoperative dysphagia can be significant and consequently we recommend preoperative swallowing evaluation and counseling.
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Affiliation(s)
- James R White
- Department of Otolaryngology Head Neck Surgery, LSU Health Sciences Center, New Orleans
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37
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Tosun F, Durmaz A, Deveci MS, Hidir Y. Endoscopic transnasal transpterygoid approach for parasphenoidal myxoma. Skull Base 2011; 19:349-52. [PMID: 20190945 DOI: 10.1055/s-0029-1220200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The parasphenoidal region is a difficult location to gain access to and contains a lot of vital neurovascular structures that have risk of injury during surgery. The transnasal endoscopic approach for this region has been described in several cadaveric studies in recent years. Herein we present a case of parasphenoidal myxoma, extending to the anteroinferior border of the cavernous sinus in a 48-year-old woman. The tumor was completely removed by the endoscopic transnasal transpterygoid approach. No postoperative complication was seen. The endoscopic transnasal transpterygoid approach may be a good alternative to external approaches in selective skull base tumors.
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Affiliation(s)
- Fuat Tosun
- Department of Otolaryngology-Head and Neck Surgery, Gulhane Medical School, Ankara, Turkey
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Jain D, Roy S, Mehta VS. Tumor of the meninges. Neuropathology 2011; 31:194-6. [PMID: 21414033 DOI: 10.1111/j.1440-1789.2010.01195.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Deepali Jain
- Department of Pathology, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India.
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Falavigna A, Righesso O, Volquind D, Teles AR. Intramuscular myxoma of the cervical paraspinal muscle. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2009; 18 Suppl 2:245-9. [PMID: 19301043 DOI: 10.1007/s00586-009-0933-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2008] [Revised: 12/29/2008] [Accepted: 03/04/2009] [Indexed: 10/21/2022]
Abstract
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.
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Affiliation(s)
- Asdrubal Falavigna
- Department of Neurosurgery, University of Caxias do Sul, Caxias do Sul, Brazil.
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Papadogeorgakis N, Petsinis V, Nikitakis N, Goutzanis L, Alexandridis C. Intramuscular myxoma of the masseter muscle. A case report. Oral Maxillofac Surg 2009; 13:37-40. [PMID: 18989712 DOI: 10.1007/s10006-008-0140-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE Myxomas are benign, locally infiltrative, connective tissue tumors that rarely occur in the head and neck region. The purpose of this paper is to describe a very rare case of an intramuscular myxoma of the masseter muscle. METHODS A 74-year-old man presented with a 2-year history of a painless swelling over his left preauricular region. Computed tomography scan showed an intramasseter well-defined soft tissue mass. After a preauricular approach, a circumscribed solid gelatinous tumor was excised with thin margins including adjacent muscle tissue. RESULTS Histopathology revealed an intramuscular myxoma, completely resected. The patient made an uneventful recovery, and there were no signs of recurrence 26 months after surgery. CONCLUSIONS Intramuscular myxoma of the masseter is an extremely rare entity, but it must be considered in the differential diagnosis of the swellings of the preauricular region.
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Rocha AC, Gaujac C, Ceccheti MM, Amato-Filho G, Machado GG. Treatment of recurrent mandibular myxoma by curettage and cryotherapy after thirty years. Clinics (Sao Paulo) 2009; 64:149-52. [PMID: 19219321 PMCID: PMC2666483 DOI: 10.1590/s1807-59322009000200013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Nakano K, Chelvanayagam P, Born K, Siar CH, Ng KH, Nagatsuka H, Kawakami T. A study of recurrent giant odontogenic myxoma of the mandible with immunohistochemical examination of Notch. ACTA ACUST UNITED AC 2008. [DOI: 10.3353/omp.12.53] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Yin H, Cai BW, An HM, You C. Huge primary myxoma of skull base: a report of an uncommon case. Acta Neurochir (Wien) 2007; 149:713-7. [PMID: 17558455 DOI: 10.1007/s00701-007-1225-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2007] [Accepted: 05/09/2007] [Indexed: 02/05/2023]
Abstract
We report a 27-year-old male who presented with paroxysmal headache, stuffy nose, epistaxis and impairment of vision in each eye. A huge chondrosarcoma, arising from the skull base with extension into the middle cranial fossa and nasal cavity was suspected. The patient underwent craniotomy and endoscope-assisted transnasal resection and a satisfactory removal was achieved. Postoperative immunohistochemical examination confirmed the diagnosis of myxoma rather than chondrosarcoma. The patient remained neurologically intact except for poor vision in the left eye at six-month follow-up. The relevant literature was reviewed and discussed. The main treatment of myxomas of cranial base is by surgery.
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Affiliation(s)
- H Yin
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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DeFatta RJ, Verret DJ, Ducic Y, Carrick K. Giant myxomas of the maxillofacial skeleton and skull base. Otolaryngol Head Neck Surg 2006; 134:931-5. [PMID: 16730532 DOI: 10.1016/j.otohns.2006.02.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2005] [Accepted: 02/03/2006] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To review our experience with patients diagnosed with giant myxomas of the maxillofacial skeleton. STUDY DESIGN All patients undergoing excision of myxomas of the head and neck from September 1998 through September 2003 with a minimum follow-up of 1 year by the senior author (YD) were included in the study. METHODS A retrospective chart review was conducted to select all patients who met the inclusion criteria. Clinical presentation, preoperative radiology findings, excisions performed, reconstruction, and follow-up were recorded and reported. RESULTS Four patients were identified who met the inclusion criteria. All underwent wide en bloc excision of the tumor with various reconstructions. Complete resection was achieved in each case, and no patients have had evidence of recurrence. CONCLUSIONS Giant myxomas of the maxillofacial skeleton have been reported to have significant rates of recurrence. Wide en bloc resection with appropriate reconstruction can result in excellent quality of life postoperatively and minimize the risk of recurrence. Lesser resections may not be appropriate especially in giant myxomas because of the potential morbidity that would be associated with a multifocal recurrence. EBM RATING C-4.
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Affiliation(s)
- Robert J DeFatta
- Department of Otolaryngology-Head and Neck Surgery at the University of Texas Southwestern Medical Center, Dallas, TX 76104, USA
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Abstract
OBJECTIVE To evaluate the clinical features and incidence of true myxomas affecting the lateral skull base. MATERIAL AND METHODS Illustrative case report and review of the relevant literature. Included are all reports of myxomas according to the histopathologic definition of Stout. RESULTS Despite nine case reports, only four patients matched the histopathologic criteria of a true myxoma growing in the lateral skull base. Facial palsy occurred in three adults with additional otalgia in one and progressive hearing loss (HL) in another patient. Our patient initially presented with signs of recurrent otitis media. The mastoid cavity was involved in all patients. CONCLUSION Differential diagnosis of lesions occurring in the lateral skull base should include true myxoma. Correct diagnosis should be based on immunohistopathology to rule out malignant tumors. Radical surgery is the treatment of choice, but surgeons should respect vital structures and esthetic consequences.
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Affiliation(s)
- J P Windfuhr
- Department of Otorhinolaryngology, Plastic Head and Neck Surgery, St. Anna Hospital, Albertus Magnus Str. 33, 47259 Duisburg, Germany.
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