Intramuscular myxomas can rarely occur in the paraspinal musculature and present with aggressive imaging features, mimicking paraspinal abscesses or malignant lesions.
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Consider myxoma in paraspinal masses with aggressive features; extends anatomic spectrum but leaves open standardized diagnostics.
Intramuscular myxomas are uncommon, benign tumors of mesenchymal origin most noted for their occurrence in the left atrium. We present a rare case of intramuscular myxoma involving the paraspinal muscles of an 80-year-old woman, presenting with longstanding lower back pain. There was no focal neurological deficit. Imaging revealed a large lobulated paraspinal mass, with heterogeneous rim enhancement, causing adjacent bony changes and intraspinal extension. Open spinal biopsy with debridement and drainage of a suspected paraspinal abscess was done. The diagnosis of an intramuscular myxoma was however confirmed on histopathology. Intramuscular myxomas, particularly those occurring in distinctly uncommon locations, with aggressive features, can pose diagnostic challenges and should be included in the differential diagnosis of all paraspinal cystic lesions. J Med Cases. 2010;1(2):42-46 doi: https://doi.org/10.4021/jmc37w
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Simon Stinchcombe (2010) studied this question.
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