Abstract. Myxoma is rare in the upper leg. The current study presents the case of a large tumor in the right upper leg. The tumor extended to pelvic cavity and was found to be connected with a cystic and solid neoplasm that was adjacent to the ascending colon in the right lower quadrant. The large tumor of the upper leg had existed for 15 years and had ulcerated through the skin 4 days prior to admittance. Palliative surgery was performed, with histological findings of a myxoma. Since appendiceal mucinous neoplasms may invade organizations outside of the mucous layer of the appendix and cause secondary peritoneal myxoma, this myxoma of the upper leg probably originated from an appendiceal mucinous neoplasm.
IntroductionMyxomas are benign neoplasms that are characterized by slow growth (1). The most frequent location of those neoplasms is the cardiac muscle, where they account for 50% of all benign lesions (2). Myxoma is rare in the leg, but can occur within its muscles (1). To date, <10 cases of myxoma located in the leg have been documented (1,(3)(4)(5). Computed tomography usually shows a well-delimited mass with an absorption density between that of muscle and water. The most precise examination technique that enables diagnosis is magnetic resonance (MR) imaging (6,7), and radical removal of the whole lesion is the most effective method of treating myxomas (8). The present study reports a case of myxoma localized to the leg and interlinked with the pelvic cavity, which was treated with palliative surgery. To the best of our knowledge, this study is the first to describe the possibility of a leg myxoma originating from an appendiceal mucinous neoplasm.
Case reportAn 88-year-old female was hospitalized at Yantai Affiliated Hospital of Binzhou Medical University (Yantai, China) in January 2014 with a large tumor in the right upper leg. The tumor had existed for 15 years and had ulcerated through the skin 4 days prior to admittance. The function and appearance of the right lower limb were seriously affected. Laboratory examinations showed no abnormalities and no other symptoms were observed. The MR studies were performed by a SIEMENS Avanto 1.5T MR scanner. A large tumor (45x15x20 cm) in the right thigh was found with a slight high signal on T1-weighted imaging (Fig. 1A) and an appreciable high signal on T2-weighted imaging (Fig. 1B). The tumor extended to the pelvic cavity and was found to be connected with a cystic and solid neoplasm (Fig. 1C). Due to the older age of the patient, total resection was considered to be too traumatic. Instead, the patient underwent palliative surgery for the tumor in the upper leg, and the tumor was found to be full of brown and yellow gelatinous material. Myxoma was finally diagnosed via histological examination (Fig. 2). Following surgery, the patient recovered well and was subsequently discharged. The patient rejected further treatment and no follow-up examination was planned. At the time of writing, the patient was alive.This study was approved by the Ethics Committee of Binzh...