Introduction Benign soft tissue tumor that presents as a slow growing deeply seated mass confined within the skeletal muscle (intramuscular) myxo from greek means mucus likely develop from premature mesenchymal stem cells which differentiate into benign fibroblasts which loose their capacity to secrete collagen Epidemiology demographics occur in 40 to 60 year olds slight female predilection associated conditions commonly located in the thigh, shoulder, buttock, or upper arm Associated conditions Mazabraud's syndrome a syndrome characterized by multiple intramuscular myxomas associated with monostotic or polyostotic fibrous dysplasia myxoid liposarcomas important to differentiate from a myxoid liposarcomas, which occurs in an intermuscular location Prognosis local recurrence and metastasis uncommon Presentation Symptoms slowly growing mass may or may not be painful pain in soft tissue sarcomas is often based on compression of surrounding tissues like vessels or nerves Imaging MRI homogeneous appearance bright T2 signal dark T1 signal intramuscular location intramuscular location of myxomas is important to differentiate from myxoid liposarcoma, which occurs in an intermuscular location Studies Histology characterized by bland and hypo-cellular myxoid stroma no cellular atypia low nuclear to cytoplasmic ratio no atypical mitosis Treatment Nonoperative observation indications for asymptomatic lesions Operative marginal surgical excision indications symptomatic benign low-grade tumors neoadjuvant chemo-radiotherapy is not needed local recurrence and metastasis uncommon
QUESTIONS 1 of 2 1 2 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK You have 100% on this question. Just skip this one for now. Take This Question Anyway (OBQ09.255) A 40-year-old male presents to your office with complaints of hip/leg pain for 6 months. He is otherwise healthy and denies trauma. Radiographs, MRI, and histology images are shown in figures A through D. What treatment do you suggest for this patient? Review Topic QID: 3068 FIGURES: A B C D Type & Select Correct Answer 1 Observation 4% (90/2201) 2 Physical therapy 1% (19/2201) 3 Surgical excision 44% (964/2201) 4 Neoadjuvant chemotherapy followed by surgical excision 11% (249/2201) 5 Surgical excision followed by adjuvant radiotherapy 40% (874/2201) L 4 Select Answer to see Preferred Response SUBMIT RESPONSE 3