J Korean Neurosurg Soc.  2015 Sep;58(3):281-285. 10.3340/jkns.2015.58.3.281.

A Primary Ossifying Intracranial Myxoma Arising from the Ethmoid Sinus

• Ryu JI
• Cheong JH
• Kim JM
• Kim CH

• KMID: 2191384
• DOI: http://doi.org/10.3340/jkns.2015.58.3.281

Abstract

Myxomas are rare benign tumors that originate from mesenchymal tissue. They usually develop in the atrium of the heart, the skin, subcutaneous tissue, or bone. Involvement of the skull base with an intracranial extension is very rare and not well-described in the literature. We report a rare case of primary intracranial ossifying myxoma arising from the anterior skull base and mimicking a huge chondrosarcoma, and we review the relevant literature.

Keyword

Primary; Myxoma; Skull base; Neoplasm

MeSH Terms

Chondrosarcoma
Ethmoid Sinus*
Heart
Myxoma*
Skin
Skull Base
Subcutaneous Tissue

Figure

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  Fig. 1 Preoperative brain (A and B) facial CT (C and D) scans showing giant bony lesions arising from the right ethmoid sinus (C and D), and a low density, multi-lobulated mass with slight peripheral enhancement (A and B).

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  Fig. 2 Preoperative brain magnetic resonance (MR) images. A : Axial Flare MR image showing peripheral high signal lesion and multiple mixed iso- and low signal mass. B : Axial and coronal T2 weighted MR images demonstrating a high signal lesion and central low signal mass. C : Illustrating the giant low-signal lesion (white arrow-heads) and multi-lobulated hypo- or iso-signal mass (black arrows) with mild uneven peripheral gadolinium enhancement.

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  Fig. 3 Postoperative T1-weighted MR images with gadolinium enhancement in the axial, coronal, and sagittal plans show subacute hematoma at left frontal area (white arrows), total resection of the cystic lesion.

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  Fig. 4 Gross specimens showing the bony structure (left) and jelly-like glistening nature (right) of the resected myxoma.

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  Fig. 5 Light microscopic and immunohistochemical findings. A : Tumor tissue is largely composed of haphazardly scattered stellate cells embedded in the loose myxoid stroma and is continuously lined by pseudostratified respiratory epithelium (H&E stain, ×100). B : Tumor base shows prominent ossification with adjacent fibrous stromal reaction, which is abutting on myxoma area (H&E stain, ×40). C : High power view of ossified fibrotic area (H&E stain, ×100). D : Myxoma cells are positive for Vimentin (Left, Vimentin, ×100, black arrow) but negative for SMA (Right, SMA, ×100). SMA : smooth muscle actin.

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