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Chap 11 - MYXOMAS AND OSSIFYING FIBROMYXOID TUMOR

Published online by Cambridge University Press:  01 March 2011

By
Markku Miettinen
Edited by
Markku Miettinen
Markku Miettinen
Affiliation:
Armed Forces Institute of Pathology, Washington DC
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Summary

Myxomas encompass a heterogeneous group of clinicopathologic entities, common to which is prominent content of extracellular mucin. Soft tissue myxomas are fibroblastic-myofibroblastic neoplasms, or in some cases possibly non-neoplastic proliferations.

Cardiac myxoma is thought to originate from primitive, multipotential endocardial cells. In addition to myxomas, ossifying fibromyxoid tumor, a mesenchymal tumor of uncertain histogenesis with potentially malignant variants, is discussed in this chapter.

Common to all myxomas is the production of a mucoid intercellular substance by the fibroblastic or myofibroblastic tumor cells. Although the chemical composition of the mucins is known to vary, its analysis is not of great practical significance. The constituents include glycoproteins and proteolgycans that include neutral and acidic carbohydrate components, such as hyaluronic acid.

The apparent character of the mucoid material on hematoxylin and eosin (HE) stain depends not only on its composition but also on fixation and staining. The mucinophilic (metachromatic) quality of HE stains varies. Mucin also becomes progressively extracted into the fixative over time, and therefore specimens kept longer in the fixative typically lose mucins and the stain is less metachromatic.

INTRAMUSCULAR MYXOMA

Clinical Features

This relatively rare tumor typically presents in middle-aged adults between 40 and 70 years, with a 2:1 female predominance (Fig. 11.1). Nearly one half of the lesions occur in the thigh, with the arm and buttocks being other common locations. A wide variety of extremity locations and chest wall are among other possible sites (Fig. 11.2).

Type
Chapter
Information
Modern Soft Tissue Pathology
Tumors and Non-Neoplastic Conditions
 , pp. 308 - 334
Publisher: Cambridge University Press
Print publication year: 2010

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References

Enzinger, FM. Intramuscular myxoma. Am J Clin Pathol 1965;43:104–110.CrossRefGoogle ScholarPubMed
Kindblom, LG, Stener, B, Angervall, L. Intramuscular myxoma. Cancer 1974;34:1737–1744.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Miettinen, M, Hockerstedt, K, Reitamo, J, Totterman, S. Intramuscular myxoma: A clinicopathological study of 23 cases. Am J Clin Pathol 1985;84:265–272.CrossRefGoogle Scholar
Hashimoto, H, Tsuneyoshi, M, Daimaru, Y, Enjoji, M, Shinohara, N. Intramuscular myxoma: A clinicopathologic, immunohistochemical, and electron microscopic study. Cancer 1986;58:740–747.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
Bancroft, LW, Kransforf, MJ, Menke, DM, O'Connor, MI, Foster, WC. Intramuscular myxoma: characteristic MR imaging features. AJR Am J Roengenol 2002;178:1255–1259.CrossRefGoogle ScholarPubMed
Murphey, MD, McRae, GA, Fanburg-Smith, JC, Temple, HT, Levine, AM, Aboulafia, AJ. Imaging of soft-tissue myxoma with emphasis on CT and MR and comparison of radiologic and pathologic findings. Radiology 2002;225:215–224.CrossRefGoogle Scholar
Feldman, F. Tuberous sclerosis, neurofibromatosis, and fibrous dysplasia. In: Resnick, D. Diagnosis of Bone and Joint Diseases, Chapter 87. Vol 5, ed 5. Philadelphia, W.B. Saunders Company, 1998.Google Scholar
Wirth, WA, Leavitt, D, Enzinger, FM. Multiple intramuscular myxomas: Another extraskeletal manifestation of fibrous dysplasia. Cancer 1971;27:1167–1173.3.0.CO;2-Z>CrossRefGoogle ScholarPubMed
Ireland, DC, Soule, EH, Ivins, JC. Myxoma of the somatic soft tissues: A report of 58 patients, 3 with multiple tumors and fibrous dysplasia of the bone. Mayo Clin Proc 1973;48:401–410.Google ScholarPubMed
Szendroi, M, Rahoty, P, Antal, I, Kiss, J. Fibrous dysplasia associated with intramuscular myxoma (Mazabraud's syndrome): a long-term follow-up of three cases. J Cancer Res Clin Oncol 1998;124:401–406.Google ScholarPubMed
Faivre, L, Nivelon-Chevallier, A, Kottler, ML, Robinet, C, Khau van Kien, P, Lorcerie, B. Mazabraud syndrome in two patients: clinical overlap with McCune-Albright syndrome. Am J Med Genet 2001;99:132–136.3.0.CO;2-A>CrossRefGoogle ScholarPubMed
Nielsen, GP, O'Connell, JX, Rosenberg, AE. Intramuscular myxoma: a clinicopathologic study of 51 cases with emphasis on hypercellular and hypervascular variants. Am J Surg Pathol 1998;22:1222–1227.CrossRefGoogle ScholarPubMed
Roggen, JF, McMenamin, ME, Fletcher, CD. Cellular myxoma of soft tissue: a clinicopathologic study of 38 cases confirming indolent behaviour. Histopathology 2001;39:287–297.CrossRefGoogle Scholar
Okamoto, S, Hisaoka, M, Ushijima, M, Nakahara, S, Toyoshima, S, Hashimoto, H. Activating Gs mutation in intramuscular myxomas with and without fibrous dysplasia of bone. Virchows Arch 2000;437:133–137.CrossRefGoogle ScholarPubMed
Malchoff, CD, Reardon, G, Macgillivray, DC, Yamase, H, Rogol, AD, Malchoff, DM. An unusual presentation of McCune-Albright syndrome confirmed by an activating mutation of the Gs alpha-subunit from a bone lesion. J Clin Endocrinol Metab 1994;78:803–806.Google Scholar
Shenker, A, Weinstein, LS, Sweet, , Spiegel, AM. An activating Gs Alpha mutation is present in fibrous dysplasia of bone in the McCune-Albright syndrome. J Clin Endocr Metab 1994;79:750–755.Google ScholarPubMed
Meis, JM, Enzinger, FM. Juxta-articular myxoma: a clinical and pathologic study of 65 cases. Hum Pathol 1992;23:639–646.CrossRefGoogle ScholarPubMed
Minkoff, J, Stecker, S, Irizarry, J, Whiteman, M, Woodhouse, S. Juxta-articular myxoma: a rare cause of painful restricted motion of the knee. Arthroscopy 2003;19:E6–13.CrossRefGoogle Scholar
Sciot, R, Dal Cin, P, Samson, I, Berghe, H, Damme, B. Clonal chromosomal changes in juxta-articular myxoma. Virchows Arch 1999;434:177–180.CrossRefGoogle ScholarPubMed
Okamoto, S, Hisaoka, M, Meis-Kindblom, JM, Kindblom, LG, Hashimoto, H. Juxta-articular myxoma and intramuscular myxoma are two distinct entities: Activating GS alpha mutation at Arg 201 codon does not occur in juxta-articular myxoma. Virchows Arch 2002;440:12–15.CrossRefGoogle Scholar
Soren, A. Pathogenesis, clinic and treatment of ganglion. Arch Orthop Trauma Surg 1982;99:247–252.CrossRefGoogle ScholarPubMed
Johnson, WC, Graham, JH, Helwig, EB. Cutaneous myxoid cyst: A clinicopathological and histochemical study. JAMA 1965;191:109–116.CrossRefGoogle ScholarPubMed
Armijo, M. Mucoid cysts of the fingers: Differential diagnosis, ultrastructure, and surgical treatment. J Dermatol Surg Oncol 1981;7:317–322.CrossRefGoogle ScholarPubMed
Berker, D, Lawrence, C. Ganglion of the distal interphalangeal joint (myxoid cyst). Arch Dermatol 2001;137:607–610.Google Scholar
Carney, JA, Headington, JT, Su, WP. Cutaneous myxomas: A major component of myxomas, spotty pigmentation, and endocrine overactivity. Arch Dermatol 1986;122:790–798.CrossRefGoogle Scholar
Carney, JA. Carney complex: the complex of myxomas, spotty pigmentation, endocrine overactivity, and schwannomas. Semin Dermatol 1995;14:90–98.CrossRefGoogle ScholarPubMed
Boikos, SA, Stratakis, CA. Carney complex: the first 20 years. Curr Opin Oncol 2007;19:24–29.CrossRefGoogle ScholarPubMed
Atherton, DJ, Pitcher, DW, Wells, RS, MacDonald, DM. A syndrome of various cutaneous pigmented lesions, myxoid neurofibromata, and atrial myxoma: the NAME syndrome. Br J Dermatol 1980;103:421–429.CrossRefGoogle ScholarPubMed
Koopman, RJJ, Happle, R. Autosomal dominant transmission of the NAME syndrome (nevi, atrial myxoma, mucinosis of the skin and endocrine overactivity). Hum Genet 1991;86:300–304.CrossRefGoogle Scholar
Rhodes, AR, Silverman, RA, Harrist, TJ, Perez-Atayde, AR. Mucocutaneous lentigines, cardiomucocutaneous myxomas, and multiple blue nevi: the “LAMB” syndrome. J Am Acad Dermatol 1984;10:72–82.CrossRefGoogle ScholarPubMed
Allen, PW, Dymock, RB, MacCormac, LB. Superficial angiomyxomas with and without epithelial components: Report of 30 tumors in 28 patients. Am J Surg Pathol 1988;12:519–530.CrossRefGoogle ScholarPubMed
Fetsch, JF, Laskin, WB, Tavassoli, FA: Superficial angiomyoxoma (cutaneous myxoma): a clinicopathologic study of 17 cases arising in the genital region. Int J Gynecol Pathol 1997;16:325–334.CrossRefGoogle ScholarPubMed
Calonje, E, Guerin, D, McCormick, D, Fletcher, CD. Superficial angiomyxoma: clinico-pathologic analysis of a series of a distinctive but poorly recognized cutaneous tumors with tendency for recurrence. Am J Surg Pathol 1999;23:910–917.CrossRefGoogle Scholar
Goldstein, MM, Casey, M, Carney, JA, Basson, CT. Molecular genetic diagnosis of the familial myxoma syndrome (Carney complex). Am J Med Genet 1999;86:62–65.3.0.CO;2-1>CrossRefGoogle Scholar
Kirschner, LS, Carney, JA, Pack, SD, Taymans, SE, Giatzakis, C, Cho, YS. Mutations of the gene encoding the protein kinase A type I-alpha regulatory subunit in patients with the Carney complex. Nat Genet 2000;26:89–92.Google ScholarPubMed
Kirschner, LS, Sandrini, F, Monbo, J, Lin, JP, Carney, JA, Stratakis, CA. Genetic heterogeneity and spectrum of mutations of the PRKAR1A gene in patients with the Carney complex. Hum Mol Genet 2000;12:3037–3046.CrossRefGoogle Scholar
Griffin, KJ, Kirschner, LS, Matyakhina, L, Stergiopoulos, SG, Robinson-White, A, Lenherr, SM. A transgenic mouse bearing an antisense construct of regulatory type subunit type 1A of protein kinase A develops endocrine and other tumours: comparison with Carney complex and other PRKAR1A induced lesions. J Med Genet 2004;41:924–931.CrossRefGoogle ScholarPubMed
Johnson, WC, Helwig, EB. Focal cutaneous mucinosis. Arch Dermatol 1966;93:13–20.CrossRefGoogle Scholar
Wilk, M, Schmoeckel, C. Cutaneous focal mucinosis – a histopathological and immunohistochemical analysis of 11 cases. J Cutan Pathol 1994;21:446–452.CrossRefGoogle ScholarPubMed
Fetsch, JF, Laskin, WB, Miettinen, M. Superficial acral fibromyxoma: a clinicopathologic and immunohistochemical analysis of 37 cases of a distinctive soft tissue tumor with a predilection for the fingers and toes. Hum Pathol 2001;32:704–714.CrossRefGoogle ScholarPubMed
Al-Daraji, W, Miettinen, M. Superifical acral fibromyxoma. Analysis of 27 cases, including four in the heel. J Cutan Pathol 2008;35:1020–1026.CrossRefGoogle Scholar
McNiff, JM, Subtil, A, Cowper, SE, Lazova, R, Glusac, EJ. Cellular digital fibromas: distinctive CD34-positive lesions that may mimic dermatofibrosarcoma protuberns. J Cutan Pathol 2005;32:413–418.CrossRefGoogle Scholar
Burke, AP, Virmani, R. Cardiac myxoma: A clinicopathologic study. Am J Clin Pathol 1993;100:671–680.CrossRefGoogle ScholarPubMed
Reynen, K. Cardiac myxomas. N Engl J Med 1995;333:1610–1617.CrossRefGoogle ScholarPubMed
Pucci, A, Gagliardotto, P, Zanini, C, Pansini, S, di Summa, M, Mollo, F. Histopathologic and clinical characterization of cardiac myxoma: review of 53 cases from a single institution. Am Heart J 2000;140:134–138.CrossRefGoogle ScholarPubMed
Pinede, L, Duhaut, P, Loire, R. Clinical presentation of left atrial cardiac myxoma: A series of 112 consecutive cases. Medicine (Baltimore) 2001;80:159–172.CrossRefGoogle ScholarPubMed
Keeling, IM, Oberwalder, P, Anelli-Monti, M, Schuchlentz, M, Demel, U, Tilz, GP. Cardiac myxomas: 24 years of experience in 49 patients. Eur J Cardiothorac Surg 2002;22:971–977.CrossRefGoogle ScholarPubMed
Edwards, A, Bermudez, C, Plwonka, G, Berr, ML, Zamorano, J, Larrain, E. Carney's syndrome: complex myxomas. Report of four cases and review of the literature. Cardiovasc Surg 2002;10:264–275.CrossRefGoogle ScholarPubMed
Mabuchi, T, Shimizu, M, Ino, H, Yamguchi, M, Terai, H, Fujino, N. PRKAR1A gene mutation in patients with cardiac myxoma. Int J Cardiol 2005;102:273–277.CrossRefGoogle ScholarPubMed
Li, Y, Pan, Z, Ji, Y, Sheppard, M, Jeffries, DJ, Archard, LC. Herpes simplex virus type 1 infection associated with atrial myxoma. Am J Pathol 2003;163:2407–2412.CrossRefGoogle ScholarPubMed
Grebenc, ML, Rosado-de-Christensen, ML, Green, CE, Burke, AP, Galvin, JR. Cardiac myxoma: imaging features in 83 patients. Radiographics 2002;22:673–689.CrossRefGoogle ScholarPubMed
Jourdan, M, Bataille, R, Seguin, J, Zhang, XG, Chaptal, PA, Klein, B. Constitutive production on interleukin-6 and immunologic features in cardiac myxomas. Arthritis Rheum 1990;33:398–402.CrossRefGoogle ScholarPubMed
Deshpande, RP, Casselman, F, Bakir, I, Cammu, G, Wellens, F, Geest, R. Endoscopic cardiac tumor resection. Ann Thorac Surg 2007;83:2142–2146.CrossRefGoogle ScholarPubMed
Altundag, MB, Ertas, G, Ucer, AR, Durmus, S, Abanuz, H, Calicoglu, T. Brain metastasis of cardiac myxoma: case report and review of the literature. J Neurooncol 2005;75:181–184.CrossRefGoogle ScholarPubMed
Goldman, BI, Frydman, C, Harpaz, N, Ryan, SF, Loiterman, D. Glandular cardiac myxomas. Histologic, immunohistochemical, and ultrastructural evidence of epithelial differentiation. Cancer 1987;59:1767–1775.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Johansson, L. Histogenesis of cardiac myxomas. An immunohistochemical study of 19 cases, including one with glandular structures, and review of the literature. Arch Pathol Lab Med 1989;113:735–741.Google Scholar
Abenoza, P, Sibley, RK. Cardiac myxoma with glandlike structures: An immunohisto-chemical study. Arch Pathol Lab Med 1986;110:736–739.Google Scholar
Miller, DV, Tazelaar, HD, Handy, JR, Young, DA, Hernandez, JC. Thymoma arising within cardiac myxoma. Am J Surg Pathol 2005;29:1208–1213.CrossRefGoogle ScholarPubMed
Terraciano, LM, Mhawech, P, Suess, K, D'Armiento, M, Lehmann, FS, Jundt, G. Calretinin as a marker for cardiac myxoma. Diagnostic and histogenetic considerations. Am J Clin Pathol 2000;114:754–759.CrossRefGoogle Scholar
Acebo, E, Val-Bernal, JF, Gomez-Roman, JJ. Thrombomodulin, calretinin and c-kit (CD117) expression in cardiac myxoma. Histol Histopathol 2001;16:1031–1036.Google ScholarPubMed
Pucci, A, Bartoloni, G, Tessitore, E, Carney, JA, Papotti, M. Cytokeratin profile and neuroendocrine cells in the glandular component of cardiac myxoma. Virchows Arch 2003;443:618–624.CrossRefGoogle ScholarPubMed
Chu, PH, Jung, SM, Yet, TS, Lin, HC, Chu, JJ. MUC1, MUC2, and MUC5AC expressions in cardiac myxoma. Virchows Arch 20065;446:52–55.CrossRefGoogle Scholar
Feldman, PS, Horvath, E, Kovacs, K. An ultrastructural study of seven cardiac myxomas. Cancer 1979;40:2216–2232.3.0.CO;2-H>CrossRefGoogle Scholar
Govoni, E, Severi, B, Cenacchi, G, Laschi, R, Pileri, S, Rivano, MT. Ultrastructural and immunohistochemical contribution to the histogenesis of human cardiac myxomas. Ultrastruct Pathol 1988;12:221–233.CrossRefGoogle Scholar
Dijkhuizen, T, Jong, B, Meuzelaar, JJ, Molenaar, WM, Berg, E. No cytogenetic evidence for involvement of gene(s) at 2p16 in sporadic cardiac myxomas: cytogenetic changes in ten sporadic cardiac myxomas. Cancer Genet Cytogenet 2001;126:162–165.CrossRefGoogle ScholarPubMed
Guardiola, T, Horton, E, Lopez-Camarillo, L, Jones, K, Dobin, SM, Donner, LR. Cardiac myxoma: a cytogenetic study of two cases. Cancer Genet Cytogenet 2004;148:145–147.CrossRefGoogle ScholarPubMed
Ghosh, BC, Huvos, AG, Gerold, FP, Miller, TR. Myxoma of the jaw bones. Cancer 1973;31:237–240.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
Barker, BF. Odontogenic myxoma. Semin Diagn Pathol 1999;16:297–301.Google ScholarPubMed
Simon, ENM, Merkx, AW, Vuhahula, E, Ngassapa, N, Stoelinga, PJW. Odontogenic myxoma: a clinicopathologic study of 33 cases. Int J Oral Maxillofac Surg 2004;33:333–337.CrossRefGoogle Scholar
Li, TJ, Sun, LS, Luo, HY. Odontogenic myxoma: A clinicopathologic study of 25 cases. Arch Pathol Lab Med 2006;130:1799–1806.Google ScholarPubMed
Suarez, PA, Batsakis, JG, El-Naggar, AK. Don't confuse dental soft tissues with odontogenic tumors. Ann Otol Rhinol Laryngol 1996;105:490–494.CrossRefGoogle ScholarPubMed
Fellegara, G, Mody, K, Kuhn, E, Rosai, J. Normal dental papilla simulating odontogenic myxoma. Int J Surg Pathol 2007;15:282–285.CrossRefGoogle ScholarPubMed
Enzinger, FM, Weiss, SW, Liang, CY. Ossifying fibromyxoid tumor of soft parts: A clinicopathologic analysis of 59 cases. Am J Surg Pathol 1989;13:817–827.CrossRefGoogle Scholar
Miettinen, M, Finnell, V, Fetsch, JF. Ossifying fibromyxoid tumor of soft parts: A clinicopathological and immunohistochemical study of 104 cases with long-term follow-up and a critical review of literature. Am J Surg Pathol 2008;32:996–1006.CrossRefGoogle Scholar
Schofield, JB, Krausz, T, Stamp, GW, Fletcher, CD, Fisher, C, Azzopardi, JG. Ossifying fibromyxoid tumour of soft parts: immunohistochemical and ultrastructural analysis. Histopathology 1993 22;101–112.CrossRefGoogle ScholarPubMed
Miettinen, M. Ossifying fibromyxoid tumor of soft parts: Additional observations of a distinctive soft tissue tumor. Am J Clin Pathol 1991;95:142–149.CrossRefGoogle ScholarPubMed
Donner, LR. Ossifying fibromyxoid tumor of soft parts: evidence supporting schwann cell origin. Human Pathol 1992;23:200–202.CrossRefGoogle ScholarPubMed
Zamecnik, M, Michal, M, Simpson, RH, Lamovec, J, Hlavac, P, Kinkor, Z. Ossifying fibromyxoid tumor of soft parts: a report of 17 cases with emphasis on unusual histologic features. Ann Diagn Pathol 1997;1:73–81.CrossRefGoogle Scholar
Williams, SB, Ellis, GL, Meis, JM. Ossifying fibromyxoid tumour (of soft parts) of the head and neck: a clinicopathological and immunohistochemical study of nine cases. J Laryngol Otol 1993;107:75–80.CrossRefGoogle ScholarPubMed
Hanski, V, Lewicki, Z. New observations on three cases of ossifying fibromyxoid tumor of soft parts. Pat Pol 1994;45:231–238.Google ScholarPubMed
Holck, S, Pederson, JG, Ackermann, T. Ossifying fibromyxoid tumour of soft parts, with focus on unusual clinicopathological features. Histopathology 2003;42:599–604.CrossRefGoogle ScholarPubMed
Kilpatrick, SE, Ward, WG, Mozes, M, Miettinen, M, Fukunaga, M, Fletcher, CDM. Atypical and malignant variants of ossifying fibromyxoid tumor. Clinicopathologic analysis of six cases. Am J Surg Pathol 1995;19:1039–1046.CrossRefGoogle ScholarPubMed
Folpe, AL, Weiss, SW. Ossifying fibromyxoid tumor of soft parts: A clinicopathologic study of 70 cases with emphasis on atypical and malignant variants. Am J Surg Pathol 2003;27:421–431.CrossRefGoogle ScholarPubMed
Sovani, V, Velagaleti, GVN, Filipowicz, E, Gatalica, Z, Knisely, AS. Ossifying fibromyxoid tumor of soft parts: report of a case with novel cytogenetic findings. Cancer Genet Cytogenet 2001;127:1–6.CrossRefGoogle ScholarPubMed
Enzinger, FM. Intramuscular myxoma. Am J Clin Pathol 1965;43:104–110.CrossRefGoogle ScholarPubMed
Kindblom, LG, Stener, B, Angervall, L. Intramuscular myxoma. Cancer 1974;34:1737–1744.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Miettinen, M, Hockerstedt, K, Reitamo, J, Totterman, S. Intramuscular myxoma: A clinicopathological study of 23 cases. Am J Clin Pathol 1985;84:265–272.CrossRefGoogle Scholar
Hashimoto, H, Tsuneyoshi, M, Daimaru, Y, Enjoji, M, Shinohara, N. Intramuscular myxoma: A clinicopathologic, immunohistochemical, and electron microscopic study. Cancer 1986;58:740–747.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
Bancroft, LW, Kransforf, MJ, Menke, DM, O'Connor, MI, Foster, WC. Intramuscular myxoma: characteristic MR imaging features. AJR Am J Roengenol 2002;178:1255–1259.CrossRefGoogle ScholarPubMed
Murphey, MD, McRae, GA, Fanburg-Smith, JC, Temple, HT, Levine, AM, Aboulafia, AJ. Imaging of soft-tissue myxoma with emphasis on CT and MR and comparison of radiologic and pathologic findings. Radiology 2002;225:215–224.CrossRefGoogle Scholar
Feldman, F. Tuberous sclerosis, neurofibromatosis, and fibrous dysplasia. In: Resnick, D. Diagnosis of Bone and Joint Diseases, Chapter 87. Vol 5, ed 5. Philadelphia, W.B. Saunders Company, 1998.Google Scholar
Wirth, WA, Leavitt, D, Enzinger, FM. Multiple intramuscular myxomas: Another extraskeletal manifestation of fibrous dysplasia. Cancer 1971;27:1167–1173.3.0.CO;2-Z>CrossRefGoogle ScholarPubMed
Ireland, DC, Soule, EH, Ivins, JC. Myxoma of the somatic soft tissues: A report of 58 patients, 3 with multiple tumors and fibrous dysplasia of the bone. Mayo Clin Proc 1973;48:401–410.Google ScholarPubMed
Szendroi, M, Rahoty, P, Antal, I, Kiss, J. Fibrous dysplasia associated with intramuscular myxoma (Mazabraud's syndrome): a long-term follow-up of three cases. J Cancer Res Clin Oncol 1998;124:401–406.Google ScholarPubMed
Faivre, L, Nivelon-Chevallier, A, Kottler, ML, Robinet, C, Khau van Kien, P, Lorcerie, B. Mazabraud syndrome in two patients: clinical overlap with McCune-Albright syndrome. Am J Med Genet 2001;99:132–136.3.0.CO;2-A>CrossRefGoogle ScholarPubMed
Nielsen, GP, O'Connell, JX, Rosenberg, AE. Intramuscular myxoma: a clinicopathologic study of 51 cases with emphasis on hypercellular and hypervascular variants. Am J Surg Pathol 1998;22:1222–1227.CrossRefGoogle ScholarPubMed
Roggen, JF, McMenamin, ME, Fletcher, CD. Cellular myxoma of soft tissue: a clinicopathologic study of 38 cases confirming indolent behaviour. Histopathology 2001;39:287–297.CrossRefGoogle Scholar
Okamoto, S, Hisaoka, M, Ushijima, M, Nakahara, S, Toyoshima, S, Hashimoto, H. Activating Gs mutation in intramuscular myxomas with and without fibrous dysplasia of bone. Virchows Arch 2000;437:133–137.CrossRefGoogle ScholarPubMed
Malchoff, CD, Reardon, G, Macgillivray, DC, Yamase, H, Rogol, AD, Malchoff, DM. An unusual presentation of McCune-Albright syndrome confirmed by an activating mutation of the Gs alpha-subunit from a bone lesion. J Clin Endocrinol Metab 1994;78:803–806.Google Scholar
Shenker, A, Weinstein, LS, Sweet, , Spiegel, AM. An activating Gs Alpha mutation is present in fibrous dysplasia of bone in the McCune-Albright syndrome. J Clin Endocr Metab 1994;79:750–755.Google ScholarPubMed
Meis, JM, Enzinger, FM. Juxta-articular myxoma: a clinical and pathologic study of 65 cases. Hum Pathol 1992;23:639–646.CrossRefGoogle ScholarPubMed
Minkoff, J, Stecker, S, Irizarry, J, Whiteman, M, Woodhouse, S. Juxta-articular myxoma: a rare cause of painful restricted motion of the knee. Arthroscopy 2003;19:E6–13.CrossRefGoogle Scholar
Sciot, R, Dal Cin, P, Samson, I, Berghe, H, Damme, B. Clonal chromosomal changes in juxta-articular myxoma. Virchows Arch 1999;434:177–180.CrossRefGoogle ScholarPubMed
Okamoto, S, Hisaoka, M, Meis-Kindblom, JM, Kindblom, LG, Hashimoto, H. Juxta-articular myxoma and intramuscular myxoma are two distinct entities: Activating GS alpha mutation at Arg 201 codon does not occur in juxta-articular myxoma. Virchows Arch 2002;440:12–15.CrossRefGoogle Scholar
Soren, A. Pathogenesis, clinic and treatment of ganglion. Arch Orthop Trauma Surg 1982;99:247–252.CrossRefGoogle ScholarPubMed
Johnson, WC, Graham, JH, Helwig, EB. Cutaneous myxoid cyst: A clinicopathological and histochemical study. JAMA 1965;191:109–116.CrossRefGoogle ScholarPubMed
Armijo, M. Mucoid cysts of the fingers: Differential diagnosis, ultrastructure, and surgical treatment. J Dermatol Surg Oncol 1981;7:317–322.CrossRefGoogle ScholarPubMed
Berker, D, Lawrence, C. Ganglion of the distal interphalangeal joint (myxoid cyst). Arch Dermatol 2001;137:607–610.Google Scholar
Carney, JA, Headington, JT, Su, WP. Cutaneous myxomas: A major component of myxomas, spotty pigmentation, and endocrine overactivity. Arch Dermatol 1986;122:790–798.CrossRefGoogle Scholar
Carney, JA. Carney complex: the complex of myxomas, spotty pigmentation, endocrine overactivity, and schwannomas. Semin Dermatol 1995;14:90–98.CrossRefGoogle ScholarPubMed
Boikos, SA, Stratakis, CA. Carney complex: the first 20 years. Curr Opin Oncol 2007;19:24–29.CrossRefGoogle ScholarPubMed
Atherton, DJ, Pitcher, DW, Wells, RS, MacDonald, DM. A syndrome of various cutaneous pigmented lesions, myxoid neurofibromata, and atrial myxoma: the NAME syndrome. Br J Dermatol 1980;103:421–429.CrossRefGoogle ScholarPubMed
Koopman, RJJ, Happle, R. Autosomal dominant transmission of the NAME syndrome (nevi, atrial myxoma, mucinosis of the skin and endocrine overactivity). Hum Genet 1991;86:300–304.CrossRefGoogle Scholar
Rhodes, AR, Silverman, RA, Harrist, TJ, Perez-Atayde, AR. Mucocutaneous lentigines, cardiomucocutaneous myxomas, and multiple blue nevi: the “LAMB” syndrome. J Am Acad Dermatol 1984;10:72–82.CrossRefGoogle ScholarPubMed
Allen, PW, Dymock, RB, MacCormac, LB. Superficial angiomyxomas with and without epithelial components: Report of 30 tumors in 28 patients. Am J Surg Pathol 1988;12:519–530.CrossRefGoogle ScholarPubMed
Fetsch, JF, Laskin, WB, Tavassoli, FA: Superficial angiomyoxoma (cutaneous myxoma): a clinicopathologic study of 17 cases arising in the genital region. Int J Gynecol Pathol 1997;16:325–334.CrossRefGoogle ScholarPubMed
Calonje, E, Guerin, D, McCormick, D, Fletcher, CD. Superficial angiomyxoma: clinico-pathologic analysis of a series of a distinctive but poorly recognized cutaneous tumors with tendency for recurrence. Am J Surg Pathol 1999;23:910–917.CrossRefGoogle Scholar
Goldstein, MM, Casey, M, Carney, JA, Basson, CT. Molecular genetic diagnosis of the familial myxoma syndrome (Carney complex). Am J Med Genet 1999;86:62–65.3.0.CO;2-1>CrossRefGoogle Scholar
Kirschner, LS, Carney, JA, Pack, SD, Taymans, SE, Giatzakis, C, Cho, YS. Mutations of the gene encoding the protein kinase A type I-alpha regulatory subunit in patients with the Carney complex. Nat Genet 2000;26:89–92.Google ScholarPubMed
Kirschner, LS, Sandrini, F, Monbo, J, Lin, JP, Carney, JA, Stratakis, CA. Genetic heterogeneity and spectrum of mutations of the PRKAR1A gene in patients with the Carney complex. Hum Mol Genet 2000;12:3037–3046.CrossRefGoogle Scholar
Griffin, KJ, Kirschner, LS, Matyakhina, L, Stergiopoulos, SG, Robinson-White, A, Lenherr, SM. A transgenic mouse bearing an antisense construct of regulatory type subunit type 1A of protein kinase A develops endocrine and other tumours: comparison with Carney complex and other PRKAR1A induced lesions. J Med Genet 2004;41:924–931.CrossRefGoogle ScholarPubMed
Johnson, WC, Helwig, EB. Focal cutaneous mucinosis. Arch Dermatol 1966;93:13–20.CrossRefGoogle Scholar
Wilk, M, Schmoeckel, C. Cutaneous focal mucinosis – a histopathological and immunohistochemical analysis of 11 cases. J Cutan Pathol 1994;21:446–452.CrossRefGoogle ScholarPubMed
Fetsch, JF, Laskin, WB, Miettinen, M. Superficial acral fibromyxoma: a clinicopathologic and immunohistochemical analysis of 37 cases of a distinctive soft tissue tumor with a predilection for the fingers and toes. Hum Pathol 2001;32:704–714.CrossRefGoogle ScholarPubMed
Al-Daraji, W, Miettinen, M. Superifical acral fibromyxoma. Analysis of 27 cases, including four in the heel. J Cutan Pathol 2008;35:1020–1026.CrossRefGoogle Scholar
McNiff, JM, Subtil, A, Cowper, SE, Lazova, R, Glusac, EJ. Cellular digital fibromas: distinctive CD34-positive lesions that may mimic dermatofibrosarcoma protuberns. J Cutan Pathol 2005;32:413–418.CrossRefGoogle Scholar
Burke, AP, Virmani, R. Cardiac myxoma: A clinicopathologic study. Am J Clin Pathol 1993;100:671–680.CrossRefGoogle ScholarPubMed
Reynen, K. Cardiac myxomas. N Engl J Med 1995;333:1610–1617.CrossRefGoogle ScholarPubMed
Pucci, A, Gagliardotto, P, Zanini, C, Pansini, S, di Summa, M, Mollo, F. Histopathologic and clinical characterization of cardiac myxoma: review of 53 cases from a single institution. Am Heart J 2000;140:134–138.CrossRefGoogle ScholarPubMed
Pinede, L, Duhaut, P, Loire, R. Clinical presentation of left atrial cardiac myxoma: A series of 112 consecutive cases. Medicine (Baltimore) 2001;80:159–172.CrossRefGoogle ScholarPubMed
Keeling, IM, Oberwalder, P, Anelli-Monti, M, Schuchlentz, M, Demel, U, Tilz, GP. Cardiac myxomas: 24 years of experience in 49 patients. Eur J Cardiothorac Surg 2002;22:971–977.CrossRefGoogle ScholarPubMed
Edwards, A, Bermudez, C, Plwonka, G, Berr, ML, Zamorano, J, Larrain, E. Carney's syndrome: complex myxomas. Report of four cases and review of the literature. Cardiovasc Surg 2002;10:264–275.CrossRefGoogle ScholarPubMed
Mabuchi, T, Shimizu, M, Ino, H, Yamguchi, M, Terai, H, Fujino, N. PRKAR1A gene mutation in patients with cardiac myxoma. Int J Cardiol 2005;102:273–277.CrossRefGoogle ScholarPubMed
Li, Y, Pan, Z, Ji, Y, Sheppard, M, Jeffries, DJ, Archard, LC. Herpes simplex virus type 1 infection associated with atrial myxoma. Am J Pathol 2003;163:2407–2412.CrossRefGoogle ScholarPubMed
Grebenc, ML, Rosado-de-Christensen, ML, Green, CE, Burke, AP, Galvin, JR. Cardiac myxoma: imaging features in 83 patients. Radiographics 2002;22:673–689.CrossRefGoogle ScholarPubMed
Jourdan, M, Bataille, R, Seguin, J, Zhang, XG, Chaptal, PA, Klein, B. Constitutive production on interleukin-6 and immunologic features in cardiac myxomas. Arthritis Rheum 1990;33:398–402.CrossRefGoogle ScholarPubMed
Deshpande, RP, Casselman, F, Bakir, I, Cammu, G, Wellens, F, Geest, R. Endoscopic cardiac tumor resection. Ann Thorac Surg 2007;83:2142–2146.CrossRefGoogle ScholarPubMed
Altundag, MB, Ertas, G, Ucer, AR, Durmus, S, Abanuz, H, Calicoglu, T. Brain metastasis of cardiac myxoma: case report and review of the literature. J Neurooncol 2005;75:181–184.CrossRefGoogle ScholarPubMed
Goldman, BI, Frydman, C, Harpaz, N, Ryan, SF, Loiterman, D. Glandular cardiac myxomas. Histologic, immunohistochemical, and ultrastructural evidence of epithelial differentiation. Cancer 1987;59:1767–1775.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Johansson, L. Histogenesis of cardiac myxomas. An immunohistochemical study of 19 cases, including one with glandular structures, and review of the literature. Arch Pathol Lab Med 1989;113:735–741.Google Scholar
Abenoza, P, Sibley, RK. Cardiac myxoma with glandlike structures: An immunohisto-chemical study. Arch Pathol Lab Med 1986;110:736–739.Google Scholar
Miller, DV, Tazelaar, HD, Handy, JR, Young, DA, Hernandez, JC. Thymoma arising within cardiac myxoma. Am J Surg Pathol 2005;29:1208–1213.CrossRefGoogle ScholarPubMed
Terraciano, LM, Mhawech, P, Suess, K, D'Armiento, M, Lehmann, FS, Jundt, G. Calretinin as a marker for cardiac myxoma. Diagnostic and histogenetic considerations. Am J Clin Pathol 2000;114:754–759.CrossRefGoogle Scholar
Acebo, E, Val-Bernal, JF, Gomez-Roman, JJ. Thrombomodulin, calretinin and c-kit (CD117) expression in cardiac myxoma. Histol Histopathol 2001;16:1031–1036.Google ScholarPubMed
Pucci, A, Bartoloni, G, Tessitore, E, Carney, JA, Papotti, M. Cytokeratin profile and neuroendocrine cells in the glandular component of cardiac myxoma. Virchows Arch 2003;443:618–624.CrossRefGoogle ScholarPubMed
Chu, PH, Jung, SM, Yet, TS, Lin, HC, Chu, JJ. MUC1, MUC2, and MUC5AC expressions in cardiac myxoma. Virchows Arch 20065;446:52–55.CrossRefGoogle Scholar
Feldman, PS, Horvath, E, Kovacs, K. An ultrastructural study of seven cardiac myxomas. Cancer 1979;40:2216–2232.3.0.CO;2-H>CrossRefGoogle Scholar
Govoni, E, Severi, B, Cenacchi, G, Laschi, R, Pileri, S, Rivano, MT. Ultrastructural and immunohistochemical contribution to the histogenesis of human cardiac myxomas. Ultrastruct Pathol 1988;12:221–233.CrossRefGoogle Scholar
Dijkhuizen, T, Jong, B, Meuzelaar, JJ, Molenaar, WM, Berg, E. No cytogenetic evidence for involvement of gene(s) at 2p16 in sporadic cardiac myxomas: cytogenetic changes in ten sporadic cardiac myxomas. Cancer Genet Cytogenet 2001;126:162–165.CrossRefGoogle ScholarPubMed
Guardiola, T, Horton, E, Lopez-Camarillo, L, Jones, K, Dobin, SM, Donner, LR. Cardiac myxoma: a cytogenetic study of two cases. Cancer Genet Cytogenet 2004;148:145–147.CrossRefGoogle ScholarPubMed
Ghosh, BC, Huvos, AG, Gerold, FP, Miller, TR. Myxoma of the jaw bones. Cancer 1973;31:237–240.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
Barker, BF. Odontogenic myxoma. Semin Diagn Pathol 1999;16:297–301.Google ScholarPubMed
Simon, ENM, Merkx, AW, Vuhahula, E, Ngassapa, N, Stoelinga, PJW. Odontogenic myxoma: a clinicopathologic study of 33 cases. Int J Oral Maxillofac Surg 2004;33:333–337.CrossRefGoogle Scholar
Li, TJ, Sun, LS, Luo, HY. Odontogenic myxoma: A clinicopathologic study of 25 cases. Arch Pathol Lab Med 2006;130:1799–1806.Google ScholarPubMed
Suarez, PA, Batsakis, JG, El-Naggar, AK. Don't confuse dental soft tissues with odontogenic tumors. Ann Otol Rhinol Laryngol 1996;105:490–494.CrossRefGoogle ScholarPubMed
Fellegara, G, Mody, K, Kuhn, E, Rosai, J. Normal dental papilla simulating odontogenic myxoma. Int J Surg Pathol 2007;15:282–285.CrossRefGoogle ScholarPubMed
Enzinger, FM, Weiss, SW, Liang, CY. Ossifying fibromyxoid tumor of soft parts: A clinicopathologic analysis of 59 cases. Am J Surg Pathol 1989;13:817–827.CrossRefGoogle Scholar
Miettinen, M, Finnell, V, Fetsch, JF. Ossifying fibromyxoid tumor of soft parts: A clinicopathological and immunohistochemical study of 104 cases with long-term follow-up and a critical review of literature. Am J Surg Pathol 2008;32:996–1006.CrossRefGoogle Scholar
Schofield, JB, Krausz, T, Stamp, GW, Fletcher, CD, Fisher, C, Azzopardi, JG. Ossifying fibromyxoid tumour of soft parts: immunohistochemical and ultrastructural analysis. Histopathology 1993 22;101–112.CrossRefGoogle ScholarPubMed
Miettinen, M. Ossifying fibromyxoid tumor of soft parts: Additional observations of a distinctive soft tissue tumor. Am J Clin Pathol 1991;95:142–149.CrossRefGoogle ScholarPubMed
Donner, LR. Ossifying fibromyxoid tumor of soft parts: evidence supporting schwann cell origin. Human Pathol 1992;23:200–202.CrossRefGoogle ScholarPubMed
Zamecnik, M, Michal, M, Simpson, RH, Lamovec, J, Hlavac, P, Kinkor, Z. Ossifying fibromyxoid tumor of soft parts: a report of 17 cases with emphasis on unusual histologic features. Ann Diagn Pathol 1997;1:73–81.CrossRefGoogle Scholar
Williams, SB, Ellis, GL, Meis, JM. Ossifying fibromyxoid tumour (of soft parts) of the head and neck: a clinicopathological and immunohistochemical study of nine cases. J Laryngol Otol 1993;107:75–80.CrossRefGoogle ScholarPubMed
Hanski, V, Lewicki, Z. New observations on three cases of ossifying fibromyxoid tumor of soft parts. Pat Pol 1994;45:231–238.Google ScholarPubMed
Holck, S, Pederson, JG, Ackermann, T. Ossifying fibromyxoid tumour of soft parts, with focus on unusual clinicopathological features. Histopathology 2003;42:599–604.CrossRefGoogle ScholarPubMed
Kilpatrick, SE, Ward, WG, Mozes, M, Miettinen, M, Fukunaga, M, Fletcher, CDM. Atypical and malignant variants of ossifying fibromyxoid tumor. Clinicopathologic analysis of six cases. Am J Surg Pathol 1995;19:1039–1046.CrossRefGoogle ScholarPubMed
Folpe, AL, Weiss, SW. Ossifying fibromyxoid tumor of soft parts: A clinicopathologic study of 70 cases with emphasis on atypical and malignant variants. Am J Surg Pathol 2003;27:421–431.CrossRefGoogle ScholarPubMed
Sovani, V, Velagaleti, GVN, Filipowicz, E, Gatalica, Z, Knisely, AS. Ossifying fibromyxoid tumor of soft parts: report of a case with novel cytogenetic findings. Cancer Genet Cytogenet 2001;127:1–6.CrossRefGoogle ScholarPubMed

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