An Unusual Presentation of a Cervical Paraspinal Leiomyoma in an Adolescent Female

Swarz, Jeffrey A.; Anilkumar, Arayamparambil C.; Miller, Douglas C.; Litofsky, N. Scott; Tanaka, Tomoko

doi:10.1177/1093526617706815

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…Benign and malignant soft tissue tumours with muscle differentiation are extremely rare, even more so in the paraspinal region. Only a few case reports of leiomyomas and rhabdomyomas of the paraspinal region have been described [65][66][67][68]. They present with the same features as those described in other locations (Fig.…”

Section: Myogenic Tumoursmentioning

confidence: 86%

Understanding a mass in the paraspinal region: an anatomical approach

Creze,

Ghaouche,

Missenard

et al. 2023

Insights Imaging

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The paraspinal region encompasses all tissues around the spine. The regional anatomy is complex and includes the paraspinal muscles, spinal nerves, sympathetic chains, Batson’s venous plexus and a rich arterial network. A wide variety of pathologies can occur in the paraspinal region, originating either from paraspinal soft tissues or the vertebral column. The most common paraspinal benign neoplasms include lipomas, fibroblastic tumours and benign peripheral nerve sheath tumours. Tumour-like masses such as haematomas, extramedullary haematopoiesis or abscesses should be considered in patients with suggestive medical histories. Malignant neoplasms are less frequent than benign processes and include liposarcomas and undifferentiated sarcomas. Secondary and primary spinal tumours may present as midline expansile soft tissue masses invading the adjacent paraspinal region. Knowledge of the anatomy of the paraspinal region is of major importance since it allows understanding of the complex locoregional tumour spread that can occur via many adipose corridors, haematogenous pathways and direct contact. Paraspinal tumours can extend into other anatomical regions, such as the retroperitoneum, pleura, posterior mediastinum, intercostal space or extradural neural axis compartment. Imaging plays a crucial role in formulating a hypothesis regarding the aetiology of the mass and tumour staging, which informs preoperative planning. Understanding the complex relationship between the different elements and the imaging features of common paraspinal masses is fundamental to achieving a correct diagnosis and adequate patient management. This review gives an overview of the anatomy of the paraspinal region and describes imaging features of the main tumours and tumour-like lesions that occur in the region.

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Section: Myogenic Tumoursmentioning

confidence: 86%

Understanding a mass in the paraspinal region: an anatomical approach

Creze,

Ghaouche,

Missenard

et al. 2023

Insights Imaging

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“…is said to contain CD45-positive lymphocytes. 1 Although this case could represent a leiomyoma, performing EBER ISH would be advisable before drawing definitive conclusions.…”

mentioning

confidence: 96%

“…To rule out the latter, they state that a “negative EBV LMP immunostain was further evidence against an immunosuppression-related smooth muscle neoplasm” in this case. 1 However, immunohistochemistry for latent membrane protein 1 is typically negative or only focally positive in EBV-associated smooth muscle tumors (SMT). EBV in situ hybridization (ISH) with EBER (EBV-encoded RNAs), in contrast, is consistently positive.…”

mentioning

confidence: 99%

Paraspinal Leiomyoma

Huppmann

2018

Pediatr Dev Pathol

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To the Editor, I read with interest the recent publication by Swarz et al. regarding a 14-year-old girl with a diagnosis of cervical paraspinal leiomyoma. The authors astutely note the importance of excluding hereditary leiomyomatosis and renal cell cancer syndrome, Li-Fraumeni syndrome, and Epstein-Barr virus (EBV)-associated smooth muscle tumors. To rule out the latter, they state that a ''negative EBV LMP immunostain was further evidence against an immunosuppression-related smooth muscle neoplasm'' in this case. 1 However, immunohistochemistry for latent membrane protein 1 is typically negative or only focally positive in EBV-associated smooth muscle tumors (SMT). EBV in situ hybridization (ISH) with EBER (EBV-encoded RNAs), in contrast, is consistently positive. 2,3 While EBV SMT is associated with congenital or acquired immunodeficiency, we have seen a case in a child with no known history of immunodeficiency at the time of diagnosis (follow-up unknown). In addition, one of the histologic features of EBV SMT is tumor infiltration by T cells, 4 and the lesion described by Swarz et al. is said to contain CD45-positive lymphocytes. 1 Although this case could represent a leiomyoma, performing EBER ISH would be advisable before drawing definitive conclusions. Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Leiomyogenic tumor of the spine: surgical treatments and long-term outcomes of 12 consecutive patients

He¹,

Xu²,

Li³

et al. 2020

Journal of Neurosurgery: Spine

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OBJECTIVELeiomyogenic tumor of the spine is rare with limited published information. Here, the authors report the clinical features and long-term surgical outcomes and investigate the prognostic factors affecting disease-free survival (DFS).METHODSTwelve patients presented to the authors’ institution for surgical treatment from January 2005 to December 2018. The clinical characteristics and outcomes were retrospectively reviewed, and the DFS rate was estimated using the Kaplan-Meier method. The log-rank test was used to identify the potential prognostic factors, with p < 0.05 considered statistically significant.RESULTSThe mean patient age was 49.7 ± 12.9 years (range 22–73 years). Four patients underwent marginal en bloc resection, and 8 patients underwent conventional piecemeal resection. Pathological diagnosis revealed leiomyosarcoma in 9 patients and leiomyoma in 3 patients. Three patients had tumor recurrence at a mean follow-up of 10.4 months (range 7.0–15.0 months), while 4 developed metastases at an average of 13.8 months (range 5.5–21.3 months) postoperatively. During the mean follow-up of 33.7 months (range 9.6–78.5 months), the estimated 1- and 5-year DFS rates were 66.7% and 38.2%, respectively. Albumin loss > 20 g/L after surgery, Ki-67 positivity > 10%, and piecemeal resection were correlated with worse DFS.CONCLUSIONSSurgical management of spinal leiomyogenic tumors is challenging due to the high rate of recurrence and metastases. En bloc resection should be performed in eligible patients. Albumin loss > 20 g/L and the Ki-67 index may be independent factors affecting prognosis.

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An Unusual Presentation of a Cervical Paraspinal Leiomyoma in an Adolescent Female

Cited by 3 publications

References 18 publications

Understanding a mass in the paraspinal region: an anatomical approach

Understanding a mass in the paraspinal region: an anatomical approach

Paraspinal Leiomyoma

Leiomyogenic tumor of the spine: surgical treatments and long-term outcomes of 12 consecutive patients

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