title: Infiltrative intramuscular myxoma of the cervical spine: a case report.
abstract: BACKGROUND
  Myxomas are benign tumors of mesenchymal cell origin that usually present as solitary lesions. They are infrequently associated with fibrous dysplasia, as in McCune-Albright or Mazabraud syndrome. Myxomas can develop in a variety of locations, although the most frequent sites are the thigh, buttocks, shoulder, and upper arm. Intramuscular myxomas (IMs) refer to lesions that occur within muscle compartments. They have been infrequently reported in the neck musculature.
  
  
  OBJECTIVE
  To date, only five cases have been reported within the posterior neck muscles without associated intraspinal extension. To our knowledge, this is the first case of an IM presenting with extension into the spinal canal.
  
  
  METHODS
  We report a case of posterior cervical IM with intraspinal extension presenting in a 63-year-old woman as a palpable mass.
  
  
  METHODS
  Complete intralesional resection of the tumor was achieved by standard midline posterior approach. Meticulous resection of the entire capsule was achieved and all margins were confirmed to be free of neoplasm.
  
  
  RESULTS
  A diagnosis of myxoma was provided on pathologic evaluation. Follow-up at 1.5 years confirmed maintained complete resolution of the preoperative symptoms, with no evidence of local recurrence on imaging.
  
  
  CONCLUSIONS
  Intramuscular myxomas should be included in the differential diagnosis of cervical paraspinal tumors. Furthermore, we suggest that masses involving the axial muscles should be closely monitored and the patient counseled regarding potential neurologic sequelae.
authors.affiliation: Department of Neurological Surgery, Ohio State University Wexner Medical Center, 410 W. 10th Ave., Columbus, Ohio 43210, USA.
authors.forename: Sakthivel Rajan Rajaram
authors.initials: SR
authors.lastname: Manoharan
authors.affiliation: Department of Neurological Surgery, Ohio State University Wexner Medical Center, 410 W. 10th Ave., Columbus, Ohio 43210, USA.
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Shaw
authors.affiliation: Department of Pathology, Ohio State University Wexner Medical Center, 410 W. 10th Ave., Columbus, Ohio 43210, USA.
authors.forename: Christina A
authors.initials: CA
authors.lastname: Arnold
authors.affiliation: Department of Neurological Surgery, Ohio State University Wexner Medical Center, 410 W. 10th Ave., Columbus, Ohio 43210, USA. Electronic address: Francis.Farhadi@osumc.edu.
authors.forename: H Francis
authors.initials: HF
authors.lastname: Farhadi
mesh_terms: D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D009232:Myxoma / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Cervical spine myxoma; Cord compression; Infiltrative myxoma; Intramuscular myxoma; Lytic spine lesion; Spinal tumor