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Case Reports
. 2015 Aug 19:2015:bcr2015211480.
doi: 10.1136/bcr-2015-211480.

Myxoma of the femur: an unusual site of origin

Siva Swaminathan Santhanam  1 , Vijay Goni  1 , Balaji Saibaba  1 , Ashim Das  2
Affiliations
Case Reports

Myxoma of the femur: an unusual site of origin

Siva Swaminathan Santhanam et al. BMJ Case Rep. .

Abstract

Skeletal myxomas are rare benign tumours. Their occurrence in long bones of the extremities is rarely reported. A 45-year-old man presented with pain in his left proximal thigh for a duration of 4 months. Movements of the hip were painful. Radiography revealed an expansile osteolytic lesion in the left proximal femur near the lesser trochanteric region. On MRI, the lesion showed a homogenous signal enhancement with no cortical disruption. Extended curettage and bone grafting was performed. On gross examination, the curetted specimen was a yellowish-white mucoid material. Histopathology showed a tumour consisting of spindle-shaped and stellate-shaped cells with widely separated myxoid mucoidy stroma, suggestive of intraosseous myxoma. At 2 years follow-up, there were no signs of recurrence and the patient was doing well with excellent hip and knee function.

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Figures

Figure 1
Figure 1
Preoperative X-ray showing an osteolytic lesion in the left proximal femur.
Figure 2
Figure 2
CT scan showing an expansile osteolytic lesion without cortical breach.
Figure 3
Figure 3
T2-weighted MRI showing a homogenous hyperintense lesion in the left proximal femur.
Figure 4
Figure 4
Intra-operative picture showing a yellowish-white mucoid tumour material.
Figure 5
Figure 5
Histopathological photomicrograph showing tumour composed of many monomorphic spindle-shaped to stellate-shaped cells in a myxoid background (H&E ×200).
Figure 6
Figure 6
(A) The tumour cells show strong vimentin positivity (immuno-peroxide (IP) ×100). (B) Some of the tumour cells show faint positivity for smooth muscle actin, while blood vessels show strong positivity (IP ×200).
Figure 7
Figure 7
Postoperative X-ray at 2 years follow-up.
See this image and copyright information in PMC

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