Fibromyxoma of the Lateral Skull Base in a Child: Case Report

Paul Klimo Jr.; Tushar Jha; Asim F. Choudhri; Royce Joyner; L. Madison Michael II

doi:10.1055/s-0033-1351115

Journal of Neurological Surgery Reports, Table of Contents

J Neurol Surg Rep 2013; 74(02): 105-110
DOI: 10.1055/s-0033-1351115

Georg Thieme Verlag KG Stuttgart · New York

Fibromyxoma of the Lateral Skull Base in a Child: Case Report

Authors

Paul Klimo Jr.

¹Murphey Neurologic & Spine Institute, Semmes, Memphis, Tennessee, United States

²Le Bonheur Children's Hospital, Memphis, Tennessee, United States

³Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States

⁴St. Jude Children's Research Hospital, Memphis, Tennessee, United States
Tushar Jha

⁵Department of Neurosurgery, Georgetown University, Washington, District of Columbia, United States
Asim F. Choudhri

²Le Bonheur Children's Hospital, Memphis, Tennessee, United States

³Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States

⁶Department of Radiology, University of Tennessee Health Science Center, Memphis, Tennessee, United States
Royce Joyner

²Le Bonheur Children's Hospital, Memphis, Tennessee, United States

⁷Department of Pathology, University of Tennessee Health Science Center, Memphis, Tennessee, United States
L. Madison Michael II

¹Murphey Neurologic & Spine Institute, Semmes, Memphis, Tennessee, United States

³Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Abstract

Purpose Fibromyxomas and myxomas are benign tumors of mesenchymal origin usually found outside the nervous system, most commonly in the atrium of the heart. They can also arise in the mandible or maxilla, but it is exceedingly rare to find them within the skull base. The history, histologic features, and the literature, with emphasis on other pediatric cases, are reviewed for this uncommon skull base neoplasm.

Methods We describe the case of a 13-year-old girl who presented with a 1-year history of facial weakness, numbness, and hearing loss. A large locally destructive tumor centered in the petrous bone was found on magnetic resonance imaging.

Results A mastoidectomy combined with a middle fossa craniotomy was performed for gross total resection. The child is disease free 12 months after surgery.

Conclusion Diagnosis could not be made solely on radiographic studies because of the lack of pathognomonic imaging features. Radical resection provided the patient the best chance of cure. Long-term surveillance is necessary to monitor for tumor recurrence.

Keywords

fibromyxoma - myxoma - child - pediatric - skull base - petrous - mesenchymal - tumor - benign

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References

References
1 Chapman PR, Shah R, Curé JK, Bag AK. Petrous apex lesions: pictorial review. AJR Am J Roentgenol 2011; 196 (3, Suppl): WS26-WS37 ; quiz S40–S43
2 Erdem Y, Koktekir E, Bayar MA, Yilmaz A, Caydere M. Characterization of an intracranial neurothekeoma: case report. Turk Neurosurg 2012; 22 (1) 109-112
3 Frank E, Deruaz JP, de Tribolet N. Chondromyxoid fibroma of the petrous-sphenoid junction. Surg Neurol 1987; 27 (2) 182-186
4 Oruckaptan HH, Sarac S, Gedikoglu G. Primary intracranial myxoma of the lateral skull base: a rare entity in clinical practice. Turk Neurosurg 2010; 20 (1) 86-89
5 Osterdock RJ, Greene S, Mascott CR, Amedee R, Crawford BE. Primary myxoma of the temporal bone in a 17-year-old boy: case report. Neurosurgery 2001; 48 (4) 945-947 ; discussion 947–948
6 Srinivasan US. Fibromyxoma of the petrous apex. Pediatr Neurosurg 2000; 32 (4) 209-213
7 Ditta LC, Qayyum S, O'Brien TF, Choudhri AF, Wilson MW. Chondromyxoid fibroma of the orbit. Ophthal Plast Reconstr Surg 2012; 28 (5) e105-e106
8 Kangur TT, Dahlin DC. Myxomatous tumors of the jaws. J Oral Surg 1975; 33 (7) 523-528
9 Abiose BO, Ajagbe HA, Thomas O. Fibromyxomas of the jawbones—a study of ten cases. Br J Oral Maxillofac Surg 1987; 25 (5) 415-421
10 Choudhri AF, Parmar HA, Morales RE, Gandhi D. Lesions of the skull base: imaging for diagnosis and treatment. Otolaryngol Clin North Am 2012; 45 (6) 1385-1404
11 Duan F, Qiu S, Jiang J , et al. Characteristic CT and MRI findings of intracranial chondroma. Acta Radiol 2012; 53 (10) 1146-1154
12 Virchow R. Die Cellularpatholgie in Ihrer Begrundung auf Physiologische und Pathologische Gewebelehre. Berlin, Germany: August Hirschwald; 1871: 563
13 Stout AP. Myxoma, the tumor of primitive mesenchyme. Ann Surg 1948; 127 (4) 706-719
14 Marcove RC, Kambolis C, Bullough PG, Jaffe HL. Fibromyxoma of bone. A report of 3 cases. Cancer 1964; 17: 1209-1213
15 Keszler A, Dominguez FV, Giannunzio G. Myxoma in childhood: an analysis of 10 cases. J Oral Maxillofac Surg 1995; 53 (5) 518-521
16 Canalis RF, Smith GA, Konrad HR. Myxomas of the head and neck. Arch Otolaryngol 1976; 102 (5) 300-305
17 Aquilino R, Tuji F, Eid N, Molina O, Joo H, Neto F. Odontogenic myxoma in the maxilla: a case report and characteristics on CT and MR. Oral Oncol Extra. 2006; 42: 133-136
18 Andrews T, Kountakis SE, Maillard AA. Myxomas of the head and neck. Am J Otolaryngol 2000; 21 (3) 184-189
19 Lo Muzio L, Nocini P, Favia G, Procaccini M, Mignogna MD. Odontogenic myxoma of the jaws: a clinical, radiologic, immunohistochemical, and ultrastructural study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996; 82 (4) 426-433
20 Weiss S, Goldblum J. Benign soft tissue tumors and pseudotumors of uncertain type. In: Enzinger and Weiss's Soft Tissue Tumors. 5th ed. Philadelphia, PA: Mosby; 2008: 1063-1092
21 DeFatta RJ, Verret DJ, Ducic Y, Carrick K. Giant myxomas of the maxillofacial skeleton and skull base. Otolaryngol Head Neck Surg 2006; 134 (6) 931-935
22 Klein MV, Schwaighofer BW, Sobel DF, Hesselink JR. Primary myxoma of the posterior fossa. Neuroradiology 1990; 32 (3) 250-251
23 Liu A, Wang CC. Primary myxomas of the skull base. J Clin Neurosci 1996; 3 (1) 29-33
24 Pitkäranta A, Carpén O, Ramsay H. Fibromyxoma of the temporal bone. Otolaryngol Head Neck Surg 1997; 117 (6) S201-S203
25 Shotton JC, Kuhwoede R, Fisch U. Mesenchymal tumors of the skull base with particular reference to surgical management and outcome. Skull Base Surg 1992; 2 (2) 112-117
26 Windfuhr JP, Schwerdtfeger FP. Myxoma of the lateral skull base: clinical features and management. Laryngoscope 2004; 114 (2) 249-254
27 Yin H, Cai BW, An HM, You C. Huge primary myxoma of skull base: a report of an uncommon case. Acta Neurochir (Wien) 2007; 149 (7) 713-717
28 Zhang L, Zhang M, Zhang J , et al. Myxoma of the cranial base. Surg Neurol 2007; 68 (Suppl. 02) S22-S28
29 Nagatani M, Mori S, Takimoto N , et al. Primary myxoma in the pituitary fossa: case report. Neurosurgery 1987; 20 (2) 329-331
30 Sato H, Gyo K, Tomidokoro Y, Honda N. Myxoma of the sphenoidal sinus. Otolaryngol Head Neck Surg 2004; 130 (3) 378-380
31 LeMay DR, Sun JK, Mendel E, Hinton DR, Giannotta SL. Chondromyxoid fibroma of the temporal bone. Surg Neurol 1997; 48 (2) 148-152
32 Otto BA, Jacob A, Klein MJ, Welling DB. Chondromyxoid fibroma of the temporal bone: case report and review of the literature. Ann Otol Rhinol Laryngol 2007; 116 (12) 922-927
33 Tarhan NC, Yologlu Z, Tutar NU, Coskun M, Agildere AM, Arikan U. Chondromyxoid fibroma of the temporal bone: CT and MRI findings. Eur Radiol 2000; 10 (10) 1678-1680
34 Thompson AL, Bharatha A, Aviv RI , et al. Chondromyxoid fibroma of the mastoid facial nerve canal mimicking a facial nerve schwannoma. Laryngoscope 2009; 119 (7) 1380-1383
35 Lawton MT, Heiserman JE, Coons SW, Ragsdale BD, Spetzler RF. Juvenile active ossifying fibroma. Report of four cases. J Neurosurg 1997; 86 (2) 279-285
36 Hasselblatt M, Jundt G, Greiner C , et al. Juvenile psammomatoid ossifying fibroma of the neurocranium. Report of four cases. J Neurosurg 2005; 102 (6) 1151-1154
37 Goh EK, Cho KS, Lee IW, Chon KM. A case of isolated ossifying fibroma of the mastoid cavity of the temporal bones. Am J Otolaryngol 2006; 27 (5) 358-361
38 O'Reilly RC, Hirsch BE, Kapadia SB. Ossifying fibroma of the temporal bone. Am J Otolaryngol 2000; 21 (2) 131-135
39 Affleck BD, Malis DJ, Whittemore DE, Torgerson SJ. Psammomatoid ossifying fibroma of the temporal bone. Otolaryngol Head Neck Surg 2002; 126 (5) 585-587
40 Vlachou S, Terzakis G, Doundoulakis G, Barbati C, Papazoglou G. Ossifying fibroma of the temporal bone. J Laryngol Otol 2001; 115 (8) 654-656
41 Xin Y, Hao S, Zhang J , et al. Microsurgical treatment of intracranial chondroma. J Clin Neurosci 2011; 18 (8) 1064-1071
42 Jenny B, Kaye AH, Gonzales MF. Aggressive intracranial fibromatosis: case report. J Clin Neurosci 2002; 9 (4) 450-453
43 Madnani DD, Myssiorek D, Wasserman PG, Zahtz G, Mittler M. Jugular foramen fibromatosis in a 3-month-old male. Int J Pediatr Otorhinolaryngol 2006; 70 (12) 2119-2123
44 Dutt SN, Mirza S, Irving RM, Jones EL. Desmoplastic fibroma of the temporal bone. J Laryngol Otol 2000; 114 (4) 314-317
45 Pensak ML, Nestok BR, Van Loveren H, Shumrick KA. Desmoplastic fibroma of the temporal bone. Am J Otol 1997; 18 (5) 627-631
46 Ito M, Tajima A, Nitta T, Sato K, Ishii S, Ragsdale B. Massive cranial ossifying myxoma in a child. Clin Neurol Neurosurg 1990; 92 (3) 271-275
47 Knox GW, Roth M, Saleh H, Stiles W. A unique temporal bone lesion resembling juvenile active ossifying myxoma. Am J Otol 1996; 17 (2) 297-300