Myopericytoma: report of two cases associated with trauma

Renal myopericytoma: A case report with a literature review

Myopericytoma is a rare soft tissue tumor characterized by differentiation into perivascular muscle-like cells or perimuscular cells. This tumor primarily affects adults and is uncommon in children. It is predominantly found in the subcutaneous soft tissues of the distal limbs, and cases originating in the kidney are exceedingly rare. In this report, we present a case of a patient with renal myopericytoma admitted to our hospital. We also summarize the diagnostic and therapeutic features by reviewing relevant domestic and international literature.

Myopericytoma of the Right Middle Finger: A Case Report of an Uncommon Perivascular Neoplasm

This report describes the case of a 29-year-old male who presented with painless swelling on the volar aspect of his right middle finger. The initial clinical impression was consistent with an epidermal inclusion cyst. A plain radiograph of the lesion revealed a circumscribed superficial nodular soft tissue mass confined to the dermis of the affected finger. Following surgical excision and subsequent histopathologic examination, the lesion was ultimately identified as a myopericytoma (MPC). The occurrence of MPCs in the finger is uncommon; thus, a high level of suspicion is required to consider it as one of the differential diagnoses for painless nodules in this anatomical location. Surgery serves as the primary method for treatment, and histopathologic evaluation plays a crucial role in confirming the diagnosis and ruling out malignancy.

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.

Myopericytoma in the corpus cavernosum of the penis: A case report of a rare disease

Introduction

Myopericytomas usually occur in the extremities of older individuals; however, they also rarely occur in the penis. We report a case of myopericytoma in the corpus cavernosum of the penis and review the relevant literature.

Case presentation

A 76-year-old man presented with a slow-growing painless nodule on the left side of the penis. On physical examination, a non-tender, 7-mm mass was palpable. This tumor showed inhomogeneous low signal intensity on T2-weighted magnetic resonance imaging. The mass was excised and a myopericytoma diagnosed by pathological examination of the operative specimen.

Conclusion

We here report a rare case of myopericytoma in the corpus cavernosum of the penis. To the best of our knowledge, this is the second reported case of a myopericytoma in the penis and the first in the corpus cavernosum of the penis. Clinicians should keep this rare possibility in mind when investigating a mass in the penis.

Myopericytoma: A Review of Twenty-Three Cases Over Twelve Years and a Case Report of a Rare Neoplasm

Myopericytoma is a rare soft tissue tumor with a predilection for the distal extremities. It is commonly found in the skin and subcutaneous tissues and usually takes a benign course. Current knowledge is limited to isolated case series and reports; hence, this study aims to report our tertiary institution's experience with this uncommon entity. A review of our institution's pathology records for cases of myopericytoma was performed. From January 2009 to September 2020, 23 cases of myopericytoma were identified and their clinicopathologic features were reported. A unique case of myopericytoma of the ankle from the series was also highlighted as a case report. Among the 22 cutaneous cases, 18 were in the extremities and 4 in the head and neck. One patient had an intracranial lesion. Most patients developed asymptomatic nodules (72.2%), but 1 patient had a locally aggressive tumor on presentation. None recurred despite marginal excision in some patients (80.0%). In conclusion, pathologists and surgeons who encounter this rare neoplasm can reassure patients of its benign tendency.

Thoracic myopericytoma in an older adult, rare but possible: A case report

Myopericytoma is a rare tumor generally arising from skin and soft tissues of extremities, trunk, head, and neck regions, rarely from visceral sites. An intrathoracic visceral localization may carry a broad differential diagnosis including primary lung, pleura and chest wall lesions, or metastatic lesions. To date, any radiological features have been recognized and diagnosis of myopericytoma with intrathoracic localization remains still challenging. Here, we describe the case of a subpleural lesion incidentally diagnosed in an older adult affected by gastric cancer. Radiological features did not allow a differential diagnosis between a benign lesion, a primary tumor, or a metastasis. After resection, the histological examination showed histopathological features congruent with the diagnosis of myopericytoma. This unusual presentation reflects the need to share clinical, radiological, and histopathological data about this uncommon but frequently misdiagnosed disease.

Pre-tibial myopericytoma: a case report

Myopericytoma (MPC) is a rare, benign tumour often presenting as a cutaneous growth commonly in the lower extremities. It is distinguished by its concentric layering of spindle shaped myoid appearing cells perivascularly. These cells diagnostically stain positive to alpha smooth-muscle actin and rarely positive to desmin stain. This case study reviews the presentation of a 56-year-old male with a slow-growing, pre-tibial lesion developing over a 7–8 year period. This lesion was asymptomatic and demonstrated vascular involvement on ultrasound scan. This lesion measured 19 × 15 × 9 mm histologically and contained bland spindle cells surrounding vessels that interestingly stained positive to both alpha smooth-muscle actin and desmin. The histological findings in correlation to clinical presentation and imaging led to a diagnosis of MPC.

Ankle Myopericytoma: A Rare Case Report and Cytogenetic Study

Myopericytoma (MPC) is an uncommon benign neoplasm of the skin and soft tissues belonging to a spectrum of tumors that are histologically recognized by their distinctive perivascular myoid cell differentiation. These distinct tumors are more prevalent among middle-aged males, and they arise more frequently in the subcutaneous tissue of the four extremities. In this paper, myopericytoma is reported in a 59-year-old Saudi male, presented with a painless small cyst involving the left ankle suspected clinically to be a ganglion cyst. Following surgical excision of the cyst, the diagnosis of myopericytoma was made based on the histopathological pattern of the disease. This paper focuses on the clinical and histopathological findings of myopericytoma and emphasizes the importance of immunohistochemistry as well as molecular testing in reaching the final diagnosis.

Exophytic Nodule on the Finger

Myopericytoma is a rare, benign growth characterized by painless lesions with a predilection for the extremities, although they may be found in or on any part of the body. These tumors typically present as a rounded or dome-like non-exophytic lesion and exhibit a benign disease course. Treatment is generally reserved for cosmetic or functional purposes. We present a case of an atypical presentation of an exophytic digital myopericytoma in a 45-year-old female treated with local punch excision.

Fast growing myopericytoma of the hand: Case report and literature review

Introduction and importance

Myopericytoma (MPC) is a rare benign soft tissue neoplasm that arises from perivascular smooth muscle-like myoid cells that share features of both glomus and smooth muscle cells. It usually slow growing solitary tumor that might mimic aggressive sarcoma.

Case presentation

45 years old male, with unremarkable medical history, presented with fast growing mass on the left 1st webspace that was noticed 6 months prior to presentation. Investigations with US and MRI showed highly vascular solid mass that was worrisome for malignant lesion. Surgical excision was done and histopathology confirmed the diagnosis of myopericytoma.

Clinical discussion

MPC is a rare perivascular neoplasm that’s reported mainly in the extremities with lower limbs are most affected sites. Usually it presents as solid painless slowly growing mass. However, Multiple papers reported different rare presentations like multiple, painful and some with malignant transformation.

Conclusion

MPC is a benign tumor that might mimic aggressive sarcoma. Such cases should be approached with high suspicion and proper investigation and management should be followed promptly.

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Myopericytoma (MPC) is a rare benign soft tissue neoplasm.

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It usually slow growing solitary tumor that might mimic aggressive sarcoma.

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It occurs mainly in the extremities with lower limbs are most affected sites.

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High suspicion and proper investigation and management to achieve proper diagnosis

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.

Orbital myopericytoma: an unusual tumor in an unusual location

A 71-year-old male with a 4-month history of bulging, tearing, and redness in the right eye presented with vision loss, proptosis, conjunctival hyperemia, and chemosis. Magnetic resonance imaging showed a right intraconal solid mass with extraconal extension, hyper-intense in T2 sequences with heterogeneous contrast enhancement. Complete excision of the mass was performed through a lateral orbitotomy. Histological analysis revealed a neoplasm with high vessel density, solid growth of oval cells, a concentric proliferation of the wall of small vessels, and a weak and patchy positivity for smooth muscle actin. These findings were consistent with the diagnosis of myopericytoma. After surgery, visual acuity improved in the affected eye and after 18 months of follow-up there have been no signs of recurrence.

Radiopathological correlations of myopericytomas of the hand: emphasis on the MRI perivascular pushing growth pattern

Myopericytomas are exceedingly rare soft-tissue tumors with less than 10 cases including radiological depictions. We report three new cases of benign myopericytomas located in the soft-tissues of the hand in adult patients. A pre-treatment MRI was available for all patients and systematically evidenced well-defined, lobulated tumors closely related to the superficial palmar vascular arch and/or digital vessels with a perivascular pushing growth pattern that correlated with pathological findings. Though rare, this small case series show that myopericytomas display recurrent imaging features that could support their radiological diagnosis.

Gingival ossifying myopericytoma in a pediatric patient: Immunohistochemical analysis and literature review

Myopericytoma is a rare mesenchymal tumor characterized by a hemangiopericytoma-like vascular pattern with perivascular myoid differentiation. To date, only 11 cases of oral myopericytoma have been reported. To the best of our knowledge, myopericytoma with gingival involvement and associated with calcifications has not been reported, expanding their clinicopathological spectrum. Herein, we report a 12-year-old girl female patient who presented a gingival nodule diagnosed as ossifying myopericytoma, which should be considered in the differential diagnosis when assessing oral soft tissue lesions, especially in pediatric patients.

Spontaneous Radial Nerve Palsy due to an Unrecognized Myofibroma: A Case Report

CASE

A 33-year-old woman presented with a six-month history of spontaneous radial nerve palsy and no identified lesion on imaging. She underwent operative exploration where an hourglass deformity was seen and resected. Pathology returned as a rare tumor, a myofibroma. The patient regained full radial nerve function.

CONCLUSIONS

A trial of observation is often indicated in the cases of isolated nerve palsy where anatomic lesions have been eliminated. This case highlights that imaging studies can miss a tumor involving nerve and that painless, spontaneous nerve palsy may be a time where early surgical intervention offers a better chance of recovery.

Primary malignant myopericytoma with cancer cachexia: Report of the first case and review of literature

RATIONALE

Malignant myopericytoma is extremely rare, with a few cases described in the English literature.

PATIENT CONCERNS

This novel study aimed to report a case of malignant myopericytoma with cancer cachexia arising in the left armpit. Also, it presented a review of the English literature regarding primary malignant myopericytoma, aiming to clarify the clinical features and potentially curative treatment. A 56-year-old male presented with an ulcerated and smelly mass involving her left armpit. The patient had obvious symptoms of cancer cachexia, including emaciation, anemia, and lower extremity edema.

DIAGNOSES

Computer tomography (CT) scan demonstrated a mass in the left armpit, with no evidence of metastasis according to the chest CT, abdominal ultrasound, and emission CT. The patient underwent a core biopsy of the mass, and a diagnosis of malignant myopericytoma was rendered.

INTERVENTIONS

He received 2 standard courses of theprubicin combined with ifosfamide chemotherapy regimen with no tumor response. Then, he subsequently underwent complete excision of the tumor.

OUTCOMES

The symptoms of cancer cachexia disappeared gradually after operation. Recurrence and metastasis were not shown during follow-up for 5 years.

LESSONS

Myopericytoma are generally considered benign with an indolent clinical course, and a few reports have described malignant myopericytoma in the literature. No standard treatment is available, and complete surgical excision of the lesion may be the only potentially curative treatment. The efficacy of chemotherapy and radiation is uncertain.

Miopericitoma del pulpejo del dedo: caso clínico y revisión de la literatura

Se presenta un caso de miopericitoma, tumor benigno de extraordinaria rareza, localizado en la punta de un dedo de la mano de una mujer de 66 años de edad. El diagnóstico se efectuó tras su exéresis mediante el estudio histológico de la lesión, pues la RM no fue concluyente. Sin embargo, la resección quirúrgica constituye el tratamiento de elección, pues la recidiva local o su malignización son prácticamente inexistentes.

Traumatic Facial Myopericytoma: A Differential to Consider

Myopericytoma is a slow-growing, benign soft tissue neoplasm that arises from perivascular smooth muscle cells. This tumor is a rare entity itself, but it is only scarcely mentioned in the literature occurring secondary to trauma. The authors report a 21-year-old male patient who presented with a pulsatile mass in the medial canthal area where he had experienced previous trauma from a car accident 1-year prior. The mass was excised and histopathology revealed myopericytoma. This clinical report adds to the limited body of evidence supporting trauma as an etiology for this rare tumor.

Digital Myopericytoma: A Case Report and Systematic Literature Review

A myopericytoma (MP) is an exceedingly rare perivascular tumor of unknown etiology. Given their potential for mimicry and malignancy, MP tumors pose a unique challenge for surgeons and may be overlooked on differential diagnosis. We present a case report of an otherwise healthy 33-year-old right-hand dominant male who presented to our outpatient clinic with a 2-month history of painless swelling and erythema of the pulp of his left index finger. Subsequent plain film X-ray showed near-complete bony destruction of his distal phalanx. Pathological evaluation of an incisional biopsy showed a benign variant of MP. The lesion was treated by excision with tumor shelling, and there was no evidence of recurrence 81 days postoperatively. A systematic literature review of the management and outcome of all known cases of hand and wrist MP is presented.

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 arising adjacent to the common carotid artery: Case report and systematic review of deep located neck myopericytomas

BACKGROUND

Myopericytoma is a perivascular tumor of the skin and subcutaneous tissue of the extremities, it is a rare finding in the head and neck, and even rarer is its deep location.

METHODS

A 38-year-old woman presented with a slowly growing mass at the right carotid triangle. Contrast-enhanced CT scan revealed a moderately enhancing mass. At surgery, the tumor was firmly attached to the common carotid artery, making it necessary to excise a small portion of the vessel wall.

RESULTS

The histopathologic report was myopericytoma. The postoperative course was uneventful, without tumor recurrence.

CONCLUSION

The very few deep located myopericytomas at the head and neck region show a predilection to appear near the great neck vessels with a possibility to require vascular repair, or at the parotid space where they can be multicentric. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2479-E2482, 2016.

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.

Intravascular myopericytoma in the heel: case report and literature review

Intravascular myopericytoma (IVMP), regarded as a variant of myopericytoma, is a rare tumor. Very few cases have been described, none in the foot.The first case of IVMP located in the heel of the foot is described in this article. A literature review is reported of all cases of IVMP published in the English literature.A 48-year-old man possessed an IVMP on the heel of the right foot. The physical examination and histopathological and ultrasound studies are described. The literature review yielded 5 cases of IVMP, 2 of which were in the thigh and 1 each in the oral mucosa, the periorbital region, and the leg.The possibility that these lesions may be malignant suggests that the histopathological study of vascular tumors should include immunohistochemical tests.

Cutaneous Myopericytoma: A Report of 3 Cases and Review of the Literature

Cutaneous myopericytoma is a rarely reported mesenchymal neoplasm with a benign biologic behavior. It is seen more commonly in males and typically occurs in adults on the distal extremities. To the best of our knowledge, there are only 13 reports describing 45 cases of cutaneous myopericytoma in the literature. The 3 cases in this report expand the clinical presentation and reinforce the histopathologic features of cutaneous myopericytoma. While the clinical presentation in 2 cases (located on the scalp and heel) was in keeping with that reported previously of a slow-growing painless firm nodule, the third case, located on the dorsal wrist, presented as a scaly keratotic nodule. Histopathologic examination of all 3 cases revealed an unencapsulated dermal nodule with concentric perivascular arrangement of plump, spindle-shaped myoid cells admixed with thin-walled blood vessels. Immunohistochemical staining revealed the lesional cells to be actin- (3/3) and caldesmon- (2/3) positive and negative for other smooth muscle markers, compatible with perivascular myopericytic differentiation.

An atypical presentation of myopericytoma in palmar arch and review of the literature

Introduction. Myopericytoma is a very rare perivascular tumor that can be presented with painful mass in lower extremities. We aimed to present an atypical presentation and location of myopericytoma. Presentation of Case. An 18-year-old otherwise healthy individual was admitted to outpatient clinic with complaints of numbness and pain in his right hand. He has had no trauma. On volar aspect of his right hand, a well-circumscribed, painful mass was palpated. MRI results were related to hemangioma. Surgical excision was planned and performed. Pathological investigation revealed the mass is myopericytoma. Discussion. This case demonstrates a rare location and presentation of myopericytoma. Reviewing the literature, discussion was made to expand the horizon for diagnosis and treatment of patients with similar symptoms. Conclusion. Myopericytoma can rarely present with numbness and pain in affected region. Surgical excision is helpful for definitive diagnosis and symptom relief.

Angioleiomyoma, a rare intracranial tumor: 3 case report and a literature review

Three cases of intracranial angioleiomyoma (ALM) in our neurosurgery center are reported in detail. ALM is a benign soft tissue tumor comprised of mature smooth muscle cells and a prominent vascular component, which is extremely rare as a primary intracranial lesion. Altogether, only 12 cases were recorded in the literature to date, to the best of our knowledge. Case 1 is the second report of intra-sella ALM, a 51-year-old woman presented with visual deterioration for 2 months. An MRI showed an intra-sella 3-cm tumor, partially flame-like, enhanced with gadolinium. Using microscopic endonasal transsphenoidal approach, the tumor was completely resected with great difficulty. At 11 days post-surgery, she died of a sudden catastrophic nasal hemorrhage. An angiography revealed a pseudo-aneurysm of ICA (internal carotid artery). Case 2 is a 49-year-old man who presented with weakness of the lower limbs for 1 year. A large subtentorial mass was found affixed to the torcular and straight sinus, which was partially flame-like, dramatically enhanced as in case 1. Case 3 is that of a 77-year-old man. An ALM mass was revealed in the diploe of left temporal bone, and had eroded the inner table. Immunohistochemical workup confirmed the diagnosis of angioleiomyoma in all 3 cases. The radiology, operation, and complication of surgery in each case were discussed. In conclusion, intracranial ALMs are extremely rare, usually located ex-neuro axis (such as in our cases), in the sella, in posterior fossa, or in the skull. Magnetic resonance imaging (MRI) revealed a special feature of flame-like partial enhancement that may be helpful to distinguish ALM from pituitary tumors or meningiomas, and should result in the consideration of this rare tumor entity early on in the diagnostic process. A definitive diagnosis depends on histological analyses. The resection of ALM in certain locations is difficult and risky because of the rich blood supply.

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

BACKGROUND CONTEXT

Myopericytoma is a recently proposed term to describe a group of tumors originating from perivascular myoid cells. The tumor is most commonly located in the subcutaneous tissues and dermis of the extremities. Myopericytoma involving the skeletal system is a very rare entity, with only two such cases previously reported in literature.

PURPOSE

To present only the third reported case of myopericytoma of the spine along with a review of literature.

STUDY DESIGN

Case report with and review of literature.

METHODS

We report the case of a 50-year-old woman who presented with pain in the back with gradual onset of paraparesis. Magnetic resonance imaging showed ill-defined signal changes in the body and posterior elements of the vertebrae with epidural soft tissue mass encasing the spinal cord.

RESULTS

The patient underwent excision of the lesion with spinal fusion followed by a short course of radiotherapy. The patient recovered functional power after surgery, and at 32-month follow-up, there is no radiological evidence of recurrence of the lesion.

CONCLUSIONS

Myopericytoma should be considered in the differential diagnosis of lytic lesions of the spine. Surgery is curative; however, a short course of chemotherapy or radiotherapy may be required to prevent recurrent disease in case of incomplete tumor excision.

Cutaneous benign epithelioid peripheral nerve sheath tumour: a rare entity

Benign epithelioid peripheral nerve sheath tumor, a rare entity is an umbrella term describing benign, neural origin tumors with epithelioid morphology. Clinically indistinguishable from other benign cutaneous lesions, histopathology offers the only source of accurate diagnosis. Morphologic mimics include many benign and malignant soft tissue lesions. Besides a predominant epithelioid component, the lesion can also show a fair share of spindle cells. A circumscribed nodular tumour of low mitotic activity, it often exhibits areas resembling schwannoma or neurofibroma. An awareness of this entity and its varied morphological aspects helps to arrive at the correct diagnosis and hence avoid unnecessary extensive surgical procedures. This case presents features of this benign tumor which occurred in a 47 years old man.

Myopericytoma of the neck: sonographic appearance and sonographically guided needle biopsy

We report the imaging and pathologic findings of a case of myopericytoma of the neck in a 70-year-old woman, which was diagnosed by ultrasound-guided core-needle biopsy. The mass demonstrated homogeneous intense enhancement on contrast-enhanced CT and was markedly hypervascular on power Doppler sonography. The histopathological findings of the core biopsy were consistent with myopericytoma.

Fibro-hyaline extensions from the bony nasal aperture, causing nasal obstruction

OBJECTIVE

We report a rare case of fibro-hyaline anterior extensions of the bony nasal pyramid.

METHOD

The clinical, radiological, intra-operative and histological findings are presented.

RESULTS

A 34-year-old man presented with bilateral nasal obstruction due to enlarged lateral walls of the nasal vestibule. Radiology showed normal bony structures. Surgery revealed three histologically identical, non-malignant, fibrous masses, one in the nasal septum and one in each of the vestibular walls. The latter were attached to the bony pyramid, protruding anteriorly and converging medially.

CONCLUSION

The location and symmetry of the fibro-hyaline projections indicated that they constituted a malformation mimicking congenital bony nasal pyriform aperture stenosis. Histological analysis showed that the masses were not neoplastic.

Malignant glomus tumor of the palm: a case report

The author herein reports on a glomus tumor of the palm. A 71-year-old man consulted our hospital because of a tumor on the left palm. The tumor was deeply seated, and MRI and CT showed a deep cystic tumor adjacent to the bone. An excision of the tumor was therefore performed. Grossly, the tumor was red and partly cystic. The tumor was well defined from the surrounding tissues, and measured 25 × 24 × 22 mm. Microscopically, the tumor consisted of epithelioid perivascular cells (glomus cells) located around the blood vessels. Cystic changes and hyalinization areas were scattered. The tumor cells had moderately hyperchromatic nuclei. Nuclear pleomorphism was noticed, nucleoli were absent and apparent mitotic figures were not recognized. There were no areas of necrosis. Immunohistochemically, the glomus cells were positive for vimentin and α-smooth muscle actin. They were negative for cytokeratins, epithelial membrane antigen, CD34, CD31, factor VIII-related antigen, S100 protein, p53 protein, desmin and melanosome. The Ki-67 labeling was 5%. The tumor was diagnosed as a malignant glomus tumor because of its deep location and size > 2 cm , according to the criteria of one group. The tumor recurred 12 months later, and a further excision was performed. No metastases were found. Now, the patient is being strictly followed up.

A case of myopericytoma on the lower leg

Myopericytoma (MP) is a benign tumor composed of cells that show apparent differentiation towards putative perivascular myoid cells called myopericytes. It arises most commonly in the dermis or subcutaneous tissue of the extremities in adults. The most common presentation is a well-circumscribed, slow-growing painless firm mass. A 45-year-old woman presented with a 2-year history of a painless, slowly growing 0.9×0.7 cm sized firm mass in the subcutaneous tissue of the posterior side of the right lower leg. We presumed this lesion to be an epidermal cyst, pilomatricoma or calcinosis cutis and performed an excisional biopsy. The histologic examination showed that it was composed of spindle-shaped myoid-appearing cells in a concentric arrangement, intimately associated with thin-walled vascular channels. Lesional spindle cells were diffusely positive for smooth muscle actin and were negative for CD34, desmin and S100 protein. From these findings, we diagnosed this lesion as a myopericytoma.

Myopericytoma: A Pleural-Based Spindle Cell Neoplasm Off the Beaten Path

Myopericytoma is a recently described hemangiopericytoma-like neoplasm with myoid differentiation. These tumors are typically located in the subcutaneous and soft tissues of the extremities. The authors report a rare pleural-based pulmonary myopericytoma in a 58-year-old woman. The lesion was grossly homogeneous and well circumscribed. Microscopically, it was composed of densely packed spindle cells organized as whorls and short interlacing fascicles with a concentric perivascular distribution. Immunohistochemical reactions were positive for vimentin, smooth muscle actin (SMA), muscle-specific actin, and Bcl-2 and negative for desmin, h-caldesmon, cytokeratin, and CD34. Atypically, increased mitotic activity was noted, but no other malignant features were identified. The differential diagnoses are discussed with specific emphasis on solitary fibrous tumor of the pleura, which is the most common benign pleural-based spindle cell neoplasm and may be a diagnostic pitfall with potentially harmful consequences.

Intravascular myopericytoma: an interesting case of a long-standing large, painful subcutaneous tumor

Myopericytoma is a benign neoplasm consisting of cells that appear to have a distinct differentiation towards presumed perivascular myoid cells. Amongst myopericytoma, an intravascular variant appears to have been reported only rarely. A 67-year-old man presented with a 15-year history of a painful, slow growing 3 × 3.5 cm sized mass in the subcutis of his right lateral thigh. Histopathological studies showed a subcutaneous mass entirely within the lumen of a vein. The tumor was composed of spindle-shaped myoid-appearing cells in a concentric arrangement, intimately associated with thin-walled vascular channels. Tumor cells were diffusely positive for smooth muscle actin, focally positive for CD34, and negative for desmin and CD31. From these findings, we diagnosed this lesion as intravascular myopericytoma. Unlike previous reports, our case showed a relatively large painful subcutaneous mass, although this tumor has an intravascular nature.

Minute myopericytoma of the neck: a case report with literature review and differential diagnosis

Reports of cutaneous myopericytoma (MPC) are very rare. The author herein reports a case of minute MPC of the neck. A 56-year-old woman noticed a painful small tumor in the neck, and consulted to our hospital. Dermatologists's diagnosis is a hyperplastic lymph node. Excision of the tumor was performed. Grossly, the tumor was a sold white tumor measuring 3 × 3 × 3 mm. Microscopically, it consisted of many vascular channels and perivascular cell proliferation encased by a fibrous capsule. The vascular proliferation showed a hemangiopericytoma (HPC)-like pattern such as staghorn-like vessels. Fibrosis was not present. The HPC-like cells had vesicular nuclei and polygonal cytoplasm. No atypia is recognized. The HPC-like cells focally showed vague nodular proliferation around the vessels. Immunohistocheically, the tumor cells were negative for cytokeratin, and positive for vimentin. The vasculatures were positive for factor VIII-related antigen, CD34, and CD31. The HPC-like tumor cells were positive for α-smooth muscle actin and h-caldesmon, but negative for desmin, S100 protein, melanosome, bcl-2, CD99, and KIT. The Ki-67 labeling was 8% and p53 was negative. The pathologic diagnosis was MPC of the neck skin. The patient is now alive without recurrence 4 years after the excision. A review of the literature revealed 73 cases of MPC from 6 papers. MPC is male predominance, and the patients ages ranges from 13 to 87 years with the median of 47 years. The most common location was lower extremities followed in order by upper extremities, head and neck, and trunk. One MPC occurred within the vasculature, and 3 cases of MPC developed in the scar or trauma lesions. The prognosis after excision is good, but a very minority showed local recurrence. A differential diagnosis was also made.

Myopericytoma in patients with AIDS: a new class of Epstein-Barr virus-associated tumor

Myopericytoma is an uncommon, benign perivascular myoid cell tumor that occurs almost exclusively in somatic soft tissues. We report 2 cases occurring in patients with acquired immunodeficiency syndrome who show unusual clinical and biologic features. One patient presented with a bronchial mass and the other developed mass lesions of the tongue, vocal cord, and brain. Histologically, oval to plump spindly tumor cells with uniform nuclei and scanty cytoplasm formed sheets or cuffs around gaping or narrow vascular spaces. Focally, these areas merged into fascicles of more elongated cells with eosinophilic cytoplasm. The tumor cells were immunoreactive for actin but not desmin, and showed uniform labeling for Epstein-Barr virus (EBV) encoded RNAs on in-situ hybridization. Both patients were alive 5 years after incomplete excision of the lesions. In conjunction with another case reported in the literature, myopericytoma occurring in acquired immunodeficiency syndrome patients exhibits several features distinct from sporadic myopericytoma: presentation in anatomic sites other than somatic soft tissues, frequent presence of multifocal disease, and association with EBV. This tumor type therefore also broadens the spectrum of neoplasms associated with EBV.