A cutaneous myxoma, or superficial angiomyxoma, consists of a multilobulated myxoid mass containing stellate or spindled fibroblasts with pools of mucin forming cleft-like spaces. There is often a proliferation of blood vessels and an inflammatory infiltrate. Staining is positive for vimentin, negative for cytokeratin and desmin, and variable for CD34, Factor VIIIa, SMA, MSA and S-100.[1]
Clinically, it may present as solitary or multiple flesh-colored nodules on the face, trunk, or extremities. It may occur as part of the Carney complex, and is sometimes the first sign. Local recurrence is common.[2] Cutaneous myxoma is diagnosed based on histopathological features. The differential diagnosis for cutaneous myxoma include alopecia areata, verrucous hamartoma, cyst, fibroma, glioma, hemangioma, lipoma, scar, and nevus sebaceous. Treatment involves complete surgical excision.
Signs and symptoms
Cutaneous myxoma appears as a little, slowly expanding dermal or subcutaneous lump that typically affects adults' heads and necks.[3] Alopecic lesions have been reported,[4][5] characterized by hair tufts overlaying the lesion or even hypertrichosis.[6] Although usually painless, some people have reported experiencing discomfort or tenderness.[7][8] A pedunculated lesion was reported.[9]
A thin arborizing vascular network, a large myxoid stroma, mild to moderate cellularity with spindled to stellate cells with little or mild atypia, and the lack of nuclear pleomorphism or mitotic activity are among the histologic markers that are consistently present in cutaneous myxoma.[10]
^Brantsch, K. D.; Metzler, G.; Maennlin, S.; Breuninger, H. (2009). "A meningioma of the scalp that might have developed from a rudimentary meningocele". Clinical and Experimental Dermatology. 34 (8). Oxford University Press (OUP): e792 –e794. doi:10.1111/j.1365-2230.2009.03519.x. ISSN0307-6938. PMID19817762.
^Miyamoto, Toru; Mihara, Motoyuki; Hagari, Yoshitaka; Shimao, Shuhei (1995). "Primary Cutaneous Meningioma on the Scalp: Report of Two Siblings". The Journal of Dermatology. 22 (8). Wiley: 611–619. doi:10.1111/j.1346-8138.1995.tb03884.x. ISSN0385-2407. PMID7560462.
^Ragoowansi, Raj; Thomas, Valerie; Powell, Barry (1998). "Cutaneous meningioma of the scalp: a case report and review of literature". British Journal of Plastic Surgery. 51 (5). Elsevier BV: 402–404. doi:10.1054/bjps.1997.0204. ISSN0007-1226. PMID9771369.
^ abSharma, Anurag; Khaitan, Neha; Ko, Jennifer S.; Bergfeld, Wilma F.; Piliang, Melissa; Rubin, Brian P.; Goldblum, John R.; Billings, Steven D. (2022). "A clinicopathologic analysis of 54 cases of cutaneous myxoma". Human Pathology. 120. Elsevier BV: 71–76. doi:10.1016/j.humpath.2021.12.003. ISSN0046-8177. PMID34968506.
^Miedema, Jayson R.; Zedek, Daniel (2012-02-01). "Cutaneous Meningioma". Archives of Pathology & Laboratory Medicine. 136 (2). Archives of Pathology and Laboratory Medicine: 208–211. doi:10.5858/arpa.2010-0505-rs. ISSN0003-9985. PMID22288971.
^Ouazzani, A.; de Fontaine, S.; Berthe, J.-V. (2007). "Extracranial meningioma and pregnancy: a rare diagnosis". Journal of Plastic, Reconstructive & Aesthetic Surgery. 60 (6). Elsevier BV: 622–625. doi:10.1016/j.bjps.2006.01.054. ISSN1748-6815. PMID17485048.
Alaiti, Samer; Nelson, Fern P.; Ryoo, Jei W. (2000). "Solitary cutaneous myxoma". Journal of the American Academy of Dermatology. 43 (2). Elsevier BV: 377–379. doi:10.1067/mjd.2000.101878. ISSN0190-9622. PMID10901728.