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Research ArticleNovel Techniques & Technology

Lumbar Intramuscular Myxoma: Microsurgical Resection With Assistance From an Endoscopic Microinspection Tool

Juan Antonio Ponce-Gómez, María Fernanda Tejada-Pineda, Marco Muñuzuri-Camacho, Sergio Moreno-Jiménez, Samuel Romano-Feinholz, Victor Alcocer-Barradas, Marcela Amparo Osuna-Zazueta, José Pablo Zárate-García, Júlia Moscardini-Martelli and Luis Alberto Ortega-Porcayo
International Journal of Spine Surgery April 2025, 8733; DOI: https://doi.org/10.14444/8733
Juan Antonio Ponce-Gómez
1 Centro Médico ABC, Mexico City, Mexico
2 Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez”, Mexico City, Mexico
MD
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María Fernanda Tejada-Pineda
1 Centro Médico ABC, Mexico City, Mexico
MD
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Marco Muñuzuri-Camacho
2 Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez”, Mexico City, Mexico
MD
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Sergio Moreno-Jiménez
1 Centro Médico ABC, Mexico City, Mexico
2 Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez”, Mexico City, Mexico
MD, PHD
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Samuel Romano-Feinholz
1 Centro Médico ABC, Mexico City, Mexico
MD, MSc
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Victor Alcocer-Barradas
2 Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez”, Mexico City, Mexico
MD
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Marcela Amparo Osuna-Zazueta
1 Centro Médico ABC, Mexico City, Mexico
MD
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José Pablo Zárate-García
1 Centro Médico ABC, Mexico City, Mexico
MD
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Júlia Moscardini-Martelli
1 Centro Médico ABC, Mexico City, Mexico
MD
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Luis Alberto Ortega-Porcayo
1 Centro Médico ABC, Mexico City, Mexico
MD, MBE
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  • For correspondence: opalberto@gmail.com
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    Figure 1

    Pre- and postoperative lumbar magnetic resonance images (MRI). Preoperative imaging revealed a lobulated, well-defined lesion with a cystic appearance, measuring 5 × 5.4 × 5.5 cm, at the L3 to L4 level. Postoperative MRI showed complete resection with minimal fascia and paraspinal musculature transgression. (A) Preoperative axial T2-weighted image showed a hyperintense lesion. (B) Preoperative axial T1-weighted image showed a hypointense lesion. (C) Preoperative coronal T2-weighted image. (D) Preoperative sagittal T2-weighted image. (E) Preoperative sagittal T1-weighted image. (F) Postoperative axial T2-weighted image. (G) Postoperative axial T1-weighted image. (H) Postoperative coronal T2-weighted image. (I) Postoperative sagittal T2-weighted image. (J) Postoperative sagittal T1-weighted image.

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    Figure 2

    Histopathological findings. (A–D) Hematoxylin and eosin staining show a hypocellular lesion composed of spindle-shaped, monomorphic cells with a benign appearance, scant cytoplasm, and pale eosinophils. The nuclei are small and oval. These cells are embedded in an abundant stroma with myxoid characteristics, accompanied by a network of fine capillaries. Morphological findings were compatible with IM (magnification: A, 4×; B, 10×; C, 20×; and D, 40×). (E) Alcian blue stain is positive in the stroma. (F) Immunohistochemistry for CD34 shows focally positive cells with a proliferation index of 1%, as determined by Ki67 staining.

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    Table

    Reported cases of paraspinal intramuscular myxomas.

    ReferenceYearLocationAge, ySexPresentationOutcome
    Ponce-Gómez2025L3–L466FIntermittent lumbar pain with associated significant radiculopathy2-y follow-up, asymptomatic, and no recurrence
    Hipólito-Reis9 2023L364FLumbar pain radiates to the anterior aspect of the right thigh accompanied by numbnessAsymptomatic
    Patel11 2022C4–C577FIncidental finding of a cervical mass3-mo follow-up, asymptomatic, and no recurrence
    Patel11 2022C5–C672F5-wk history of left-sided shoulder pain radiating to the neck and upper arm in a C5 distribution, reduced manual dexterity as well paresthesia in all 4 extremities, and loss of balance3-mo follow-up, asymptomatic, and no recurrence
    Al Awadhi10 2021L4–S276FParavertebral lumbar pain, intermittent L5 radicular pain, and distal L5 paresthesiaAsymptomatic and no recurrence
    Kwon8 2016L139FSevere lower back painAsymptomatic
    Choi5 2015L4–L565FLower back pain for 3 mo without radiating leg painAsymptomatic
    Tataryn12 2015C3–C457FPosterior neck pain with a lump-
    Manoharan13 2015C4–C563FPosterior neck pain with radicular arm pain1.5 y follow-up
    Rachidi7 2014C45MPainless posterior cervical mass30-mo follow-up, asymptomatic, and no recurrence
    Ohla14 2013L5–S157FComplaints of vague pelvic discomfort3.6-y follow-up
    Rashid15 2011L2–S370FBack pain and a mass in right paravertebral region12-mo follow-up
    Stinchcombe16 2010L2–S180FLower back pain for 4 months and weight loss-
    Stinchcombe16 2010L2–S180FLower back pain-
    Taggarshe17 2010T52FIntermittent back pain3-mo follow-up
    Falavigna1 2009C2–C464FOccipital and neck pain over 5 y1-y follow-up, asymptomatic, and no recurrence
    Ishoo18 2007C22F6-mo history of a progressively enlarging posterior neck mass, with decreased cervical mobility2-y follow-up, asymptomatic, and no recurrence
    Crankson19 2002C5FProgressively enlarging neck mass over 7 mo1-y follow-up, asymptomatic, and no recurrence
    Guppy20 2001L5–S180FLower back pain for more than 20 y with radiation down the left thigh, leg, and great toe3-mo follow-up, asymptomatic, and no recurrence
    Liguoro21 1999L563FLower back pain and sciatica2 y follow-up
    Kamoun22 1997L5–S154FLower back pain and sciatica3 y follow-up
    Shugar23 1987C5–T168FAsymptomatic12 mo follow-up
    Bell24 1983L3–L460MClumsiness of the lower extremities and calf pain precipitated by walking10 mo follow-up, asymptomatic, and no recurrence
    Tahmouresie25 1981T11–T1250MSevere back pain and progressive gait disturbance-
    Feldman26 1979C62F--
    • Abbreviations: F, female; M, male.

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    [8733supp001.mov]

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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Lumbar Intramuscular Myxoma: Microsurgical Resection With Assistance From an Endoscopic Microinspection Tool
Juan Antonio Ponce-Gómez, María Fernanda Tejada-Pineda, Marco Muñuzuri-Camacho, Sergio Moreno-Jiménez, Samuel Romano-Feinholz, Victor Alcocer-Barradas, Marcela Amparo Osuna-Zazueta, José Pablo Zárate-García, Júlia Moscardini-Martelli, Luis Alberto Ortega-Porcayo
International Journal of Spine Surgery Apr 2025, 8733; DOI: 10.14444/8733

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Lumbar Intramuscular Myxoma: Microsurgical Resection With Assistance From an Endoscopic Microinspection Tool
Juan Antonio Ponce-Gómez, María Fernanda Tejada-Pineda, Marco Muñuzuri-Camacho, Sergio Moreno-Jiménez, Samuel Romano-Feinholz, Victor Alcocer-Barradas, Marcela Amparo Osuna-Zazueta, José Pablo Zárate-García, Júlia Moscardini-Martelli, Luis Alberto Ortega-Porcayo
International Journal of Spine Surgery Apr 2025, 8733; DOI: 10.14444/8733
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