Myopericytoma of the thoracic spine: a case report and review of literature

Malignant myopericytoma originating from the colon: A case report

BACKGROUND

Myopericytoma is a benign tumor that typically occurs within subcutaneous tissue and most often involves the distal extremities, followed by the proximal extremities, neck, thoracic vertebrae and oral cavity. Complete resection is often curative. Malignant myopericytoma is extremely rare and has a poor prognosis. Here, we report for the first time a case of malignant myopericytoma originating from the colon.

CASE SUMMARY

A 69-year-old male was admitted to our hospital with right upper quadrant pain for five days. Imaging suggested a liver mass with hemorrhage. A malignant hepatic tumor was the initial diagnosis. Surgical resection was performed after a complete preoperative work up. Initial postoperative pathology suggested that the mass was a malignant myoblastoma unrelated to the liver. Four months after the first surgery, an enhanced computed tomography (CT) scan revealed a recurrence of the tumor. The diagnosis of malignant myopericytoma derived from the colon was confirmed on histopathological examination of the specimen from the second surgery. The patient did not return to the hospital regularly for surveillance. The first postoperative abdominal CT examination six months after the second surgery demonstrated multiple liver metastases. Survival time between the diagnosis of the tumor to death was approximately one year.

CONCLUSION

Malignant myopericytoma is a rare cancer. Preoperative diagnosis may be difficult. Due to a lack of treatment options, prognosis is poor.

Pediatric upper lip myopericytoma: a case report and comprehensive review

BACKGROUND

Myopericytoma is a rare spindle cell tumor of mesenchymal origin, typically benign, characterized by concentric proliferation of tumor cells around blood vessels within subcutaneous tissue. It primarily occurs in middle-aged adults and is often located in distal extremities, although cases have been reported in proximal extremities and head-neck regions. However, occurrences within the oral cavity are exceedingly rare. To date, literature reviews have identified only two cases in children under 10 years old and reported only five cases of myopericytoma occurring in the lip region. We provide a comprehensive review and analysis of all documented cases to better understand this condition.

CASE PRESENTATION

A 7-year-old girl presented to oral and maxillofacial surgery with the discovery of a painless mass on the inner aspect of the upper lip. The diagnosis of myopericytoma was confirmed by histological examination (HE staining), alcian blue staining, and immunohistochemistry.

CONCLUSIONS

Following surgical excision, there were no signs of recurrence at a 3-month follow-up. The pathological diagnosis of myopericytoma is quite challenging, and immunohistochemical testing is necessary.

Myopericytoma of the patella with local recurrence and patellectomy: A case report

INTRODUCTION AND IMPORTANCE

Myopericytomas are tumors originating from perivascular myoid cells and exhibiting a wide range of histologic growth patterns. They rarely occur in bones, and no case of myopericytoma in the patella has been reported so far.

CASE PRESENTATION

A 74-year-old male presented with a chief complaint of pain in the left knee. Magnetic resonance imaging revealed bone tumor and osteolytic lesions of the patella. The patient underwent bone tumor curettage and filling of the cavity with artificial bone. However, as the tumor reoccurred, a patellectomy was performed. The patient regained premorbid functional status after surgery. Additionally, there was no radiological evidence of recurrence of the lesion 3 years after patellectomy.

CLINICAL DISCUSSION

Myopericytoma of the patella is very rare. However, it should be considered for the differential diagnosis of lytic lesions of the bone. Although surgery is curative, patellectomy may be necessary for recurrent cases.

CONCLUSION

In conclusion, we report the first case of patellar myopericytoma. Although patellar myopericytoma might be rare, it should be considered for the differential diagnosis of lytic lesions of the bone. Surgery is curative; however, patellectomy may be necessary in recurrent cases.

Intracranial Myopericytoma: A Rare Benign Tumor at an Extremely Rare Location

A 50-year-old female presented with a history of seizures, headache, nausea, and vomiting. On imaging, parafalcine meningioma with mass effect features was rendered. She underwent right frontal tumor excision and craniotomy. Pathological examination showed a tumor composed of syncytial aggregates of round to plump fusiform cells forming whorls around prominent branching congested vessels. The tumorous cells expressed α-smooth actin and heavy-chain caldesmon and were negative for epithelial membrane antigen, protein S100, HMB45, CD34, calponin, and desmin, thus providing the final diagnosis of intracranial myopericytoma.

The rarity of this benign tumor at an extremely rare location prompted this study. As preoperative radiological investigations are nonspecific in such cases, a detailed and comprehensive pathological examination is mandatory to come to a definitive diagnosis.

Primary extradural tumors of the spinal column: A comprehensive treatment guide for the spine surgeon based on the 5th Edition of the World Health Organization bone and soft-tissue tumor classification

BACKGROUND

In 2020, the World Health Organization (WHO) published the 5th version of the soft tissue and bone tumor classification. Based on this novel classification system, we reviewed the current knowledge on all tumor entities with spinal manifestations, their biologic behavior, and most importantly the appropriate treatment options as well as surgical approaches.

METHODS

All tumor entities were extracted from the WHO Soft-Tissue and Bone Tumor Classification (5th Edition). PubMed and Google Scholar were searched for the published cases of spinal tumor manifestations for each entity, and the following characteristics were extracted: Growth pattern, ability to metastasize, peak age, incidence, treatment, type of surgical resection indicated, recurrence rate, risk factors, 5-year survival rate, key molecular or genetic alterations, and possible associated tumor syndromes. Surgical treatment strategies as well as nonsurgical treatment recommendations are presented based on the biologic behavior of each lesion.

RESULTS

Out of 163 primary tumor entities of bone and soft tissue, 92 lesions have been reported along the spinal axis. Of these 92 entities, 54 have the potential to metastasize. The peak age ranges from conatal lesions to 72 years. For each tumor entity, we present recommended surgical treatment strategies based on the ability to locally destruct tissue, to grow, recur after resection, undergo malignant transformation as well as survival rates. In addition, potential systemic treatment recommendations for each tumor entity are outlined.

CONCLUSION

Based on the 5th Edition of the WHO bone and soft tumor classification, we identified 92 out of 163 tumor entities, which potentially can have spinal manifestations. Exact preoperative tissue diagnosis and interdisciplinary case discussions are crucial. Surgical resection is indicated in a significant subset of patients and has to be tailored to the specific biologic behavior of the targeted tumor entity based on the considerations outlined in detail in this article.

Imaging features of myopericytoma arising from the parotid gland: Report of 2 cases and literature review

RATIONALE

Myopericytoma of the parotid gland is a rare condition of which preoperative definitive diagnosis is relatively challenging. The purpose of this case report is to highlight the radiologic features of myopericytoma of parotid gland.

PATIENT CONCERNS

A 62-year-old man presented with a history of a walnut-size mass in left parotid gland when yawned for half-month, and a 48-year-old woman complaint about a grape-size, painless mass behind the right ear for a month.

DIAGNOSES

Radiological examinations suggested that both lesions were cyst-solid mixed lesions with relatively smoothed margins, with or without significant enhancement while the lesion without enhancement had a hemorrhage. Then a diagnosis of benign tumor arising from the parotid gland was made. Final diagnosis of myopericytoma was confirmed by histopathological and immunohistochemical examinations after surgical resection.

INTERVENTIONS

Both patients underwent excision of the tumor and the superficial parotidectomy with facial nerve preservation.

OUTCOMES

Both patients recovered without any intraoperative or postoperative complication and had no signs of recurrence during a 17-month and 5-year follow-up.

LESSONS

Parotid gland myopericytoma is an exceedingly rare tumor which diagnosis can be challenging, and this is the first published report specifying the magnetic resonance features of the disease.

Oral myopericytoma: a rare pediatric case report and a review of the literature

Background

Myopericytoma is a rare mesenchymal neoplasm with perivascular myoid differentiation that arises most commonly in middle adulthood. The lesion generally involves the subcutaneous tissue of distal extremities. Myopericytoma of the oral cavity is extremely rare. Herein we report a case of oral myopericytoma in a pediatric patient, who was treated via a conservative approach with a follow up of 8 years. The case is followed by a literature review. To our knowledge this is the first documented case of oral myopericytoma affecting a patient of such a young age.

Case presentation

A 6 years old boy was referred to the maxillofacial surgery department for the evaluation of a solitary growth of the right maxillary buccal and palatal gingiva. Histology and immunohistochemistry confirmed the diagnosis of myopericytoma.

Conclusions

Our patient was treated by local excision with no recurrence in 8 years of follow up. Conservative approach should be considered for the treatment oral myopericytoma especially in young patients in tooth bearing areas.

Imaging features of myopericytoma of the breast: A case report and review of the literature

Myopericytoma is a rare perivascular tumor commonly arising in the superficial soft tissue and subcutaneous tissue of the distal extremities. We report the first case of myopericytoma occurring in the breast, focusing on the imaging and histopathological characteristics of the tumor. From an imaging perspective, myopericytoma presents a well-circumscribed, marked hypervascularity, and intense enhancement after injection of contrast material. Imaging examinations, such as ultrasonography and magnetic resonance imaging, can contribute to the detection of tumor invasion to adjacent structures or distant metastases, and provide evidence for a treatment plan.

Myopericytoma at the Craniocervical Junction: Clinicopathological Report and Review of a Rare Perivascular Neoplasm

BACKGROUND AND IMPORTANCE

Myopericytoma is an emerging class of neoplasm originating from the perivascular myoid cellular environment, previously classified as a variant of hemangiopericytoma. Most reported myopericytomas are found in soft tissues of the extremities; however, infrequent cases are described involving the central nervous system. Intracranial myopericytoma remains rare. Here, we describe the first report of myopericytoma occurring at the cervicomedullary junction in close proximity to the vertebral artery, mimicking a vascular lesion.

CLINICAL PRESENTATION

A 64-yr-old woman presented with radiating neck pain. Magnetic resonance imaging revealed a well-circumscribed enhancing lesion adjacent to the vertebral artery-accessory nerve complex. She underwent a far lateral craniotomy and cervical laminectomy to obtain proximal vertebral artery control and adequate exposure of the lesion, which appeared most consistent with neoplasm at surgery. Histopathology revealed a grade I myopericytoma. A gross total resection was achieved, and the patient has no evidence of recurrence 3 yr after surgery.

CONCLUSION

Tumors of perivascular origin include hemangiopericytoma, glomus tumor, myofibroma, and myopericytoma and are uncommon lesions intracranially. Consideration of and distinction among these perivascular tumors is critically important, as they each have distinct clinical behaviors and management. Myopericytoma can mimic other neoplastic and cerebrovascular pathologies, but it most commonly has a benign course and can be surgically cured if a gross total resection can be achieved. Rarer myopericytoma variants that adopt a more malignant course have been described, and ongoing molecular studies may identify mutations or activated signaling pathways that can be targeted to offer chemotherapeutic options in the future.

Surgical Treatment of Primary Pulmonary Myopericytoma

Myopericytoma is a benign tumor that occurs in soft tissues. Myopericytoma in the lungs is very rare. We report the case of a 63-year-old woman presenting with cavitary masses in the left lung and multiple tiny nodules in both lungs. She underwent surgery, and a histological examination revealed primary pulmonary myopericytoma.

Intracranial myopericytoma: a tumour in a rare location

A 49-year-old female with history of headache, nausea and vomiting with some weeks of evolution, without neurological symptoms. Radiology revealed an expansive lesion near the inferior vermix and cerebellar tonsils, with heterogeneous gadolinium uptake and mass effect on the fourth ventricle, representing a probable extraventricular origin for the lesion. Pathological examination showed a proliferation of oval/spindle cell proliferation with eosinophil cytoplasm and small and monotonous nuclei, without mitoses. The cells had a concentric growth, surrounding thin-walled blood vessels with foci of stromal myxoid degeneration and whorled pattern. The vessels had a haemangiopericytoma pattern and were lined by non-atypical endothelial cells. The tumorous cells expressed vimentin, alpha-smooth actin and heavy-chain caldesmon and were negative for epithelial membrane antigen, protein S100, HMB45, CD34, calponin and desmin, thus providing the final diagnosis of intracranial myopericytoma.

Osseous Myopericytoma Simulating a Giant Cell Tumor of Bone: A Case Report

CASE

Myopericytoma is a benign perivascular myoid neoplasm that typically presents in the dermal and subcutaneous soft tissues of the distal aspect of the extremities. These types of tumor form a clinicopathological spectrum with myofibromas, angiopericytomas, angioleiomyomas, and glomus tumors. Intraosseous myopericytomas are exceptionally rare, and to our knowledge, no cases of myopericytoma involving long bones previously have been described. We present a case of myopericytoma occurring in the distal aspect of the femur of a 36-year-old man.

CONCLUSION

This case report describes a unique location of this tumor, which demonstrates that myopericytomas have a more diverse tropism than previously indicated.

Myopericytoma occurrence in the liver and stomach space: imaging performance

BACKGROUND

Myopericytoma is a rare and usually benign tumor, which is even rarer if it occurs in the liver and stomach space. Previous reports of myopericytoma were mostly related to its pathological manifestations, while imaging reports were rare. Here, we report the computed tomography (CT), computed tomography angiography (CTA) and magnetic resonance imaging (MRI) performance for one deep myopericytoma.

CASE PRESENTATION

In this study, one deep myopericytoma in the liver and stomach space is reported. A CT that was not contrast-enhanced showed a lobulated tumor with heterogeneous density, and a contrast-enhanced CT showed that the mass had progressive enhancement. CTA showed that the blood-supply of the tumor was supplied by the anterior superior pancreaticoduodenal artery and the left gastric artery. An MRI showed the lesion had isointensity on T1-weighted imaging (T1WI) and slight hyperintensity on T2-weighted imaging (T2WI). The lesion MRI enhancement characteristics were similar to the characteristics from the contrast-enhanced CT. In this case, the enhancement pattern of the tumor was the centrifugal enhancement for both the contrast-enhanced CT and MRI. After surgical resection of the tumor, the pathological diagnosis was myopericytoma, and there was no recurrence in a short-term follow-up.

CONCLUSION

The myopericytoma generally has a rich blood supply. When there is necrosis in the center lesion, the lesion has peripheral enhancement. Abdominal myopericytoma could be categorized as having centrifugal enhancement.

Myopericytoma around the knee: mimicking a neurogenic tumour

Myopericytoma is a rare, usually benign soft tissue tumour that arises most commonly in the dermis and subcutaneous soft tissue of the lower extremities. In this article, we present an unusual case of myopericytoma occurring in the deep soft tissue around the knee that mimicked a neurogenic tumour. Myopericytoma can be confused with neurogenic tumour when located in deep soft tissue and adjacent to nerve bundles. Preoperative MRI and colour Doppler ultrasound may help differentiate myopericytoma from neurogenic tumour by revealing the hypervascular nature of the tumour.

Myopericytoma of the distal forearm: a case report

Myopericytoma is a rare type of soft tissue tumor with perivascular myoid differentiation. Although the pathology characteristics of myopericytomas are well described in literature, the clinical characteristics of these tumors have received less attention. We report on a 44-year-old female who developed a myopericytoma in her right distal forearm. The patient presented with a painless solid mass that had been slowly increasing in size for approximately 5 years. Unlike typical myopericytoma in the extremity growing as a subcutaneous nodule, the tumor enveloped the distal ulna. This case suggests a different growth pattern for myopericytoma. Myopericytoma is a rare soft tissue tumor originating from perivascular myoid cells, which has only been recognized as a distinct condition in the past 15 years (Granter et al. Am J Surg Pathol. 22 (5):513-25, 1998). Most of these tumors present as a painless, slow-growing subcutaneous nodule. They have typically been described by pathologists who concentrate on the pathological features rather than the clinical characteristics of these tumors (Granter et al. Am J Surg Pathol. 22 (5):513-25, 1998; Dray et al. J Clin Pathol. 59 (1):67-73, 2006; Mentzel et al. Am J Surg Pathol. 30 (1):104-113 2006). We report a case of myopericytoma with an unusual growth pattern involving the distal forearm to highlight the clinicopathologic features of this tumor.