Periocular Myxoma in a Child

Abstract

Myxomas are locally invasive, benign mesenchymal neoplasms with odontogenic, osteogenic, or soft tissue origin. Facial myxomas probably account for less than 0.5% of all paranasal sinus and nasal tumors. We report a case of a left painless periocular mass in a 11-month-old girl. The lesion was resected with a clinical diagnosis of lacrimal sac tumor. Histopathology and immunohistochemistry proved the tumor to be a myxoma. There has been no recurrence after 4 years of followup. Midfacial myxomas should be differentiated from other benign and malignant tumors such as dermoid, hamartoma, neurofibroma, nasolacrimal duct cyst, and sarcomas in particular embryonal rhabdomyosarcoma. Because of the infiltrative nature of these tumors, a wide surgery is required to achieve clear resection margins and avoid recurrence.

Sinonasal Myxoma: A Distinct Lesion of Infants

“…Immunohistochemistry may not be a particularly helpful diagnostic adjunct when evaluating SNM. This is reflected in the case reports and series of infantile SNM since 2000, which all describe positivity for vimentin and negative staining for S100, cytokeratins, BCL2, Alk-1, other neural and muscle markers [9,10,12,22,23,25,26,[28][29][30][31]33]. SMA reactivity, when reported, was focal and weak to negative in SNM [10,23,25,[28][29][30][31], as well in our described case.…”

“…This is reflected in the case reports and series of infantile SNM since 2000, which all describe positivity for vimentin and negative staining for S100, cytokeratins, BCL2, Alk-1, other neural and muscle markers [9,10,12,22,23,25,26,[28][29][30][31]33]. SMA reactivity, when reported, was focal and weak to negative in SNM [10,23,25,[28][29][30][31], as well in our described case. Two studies have shown that most, but not all, odontogenic myxomas show reactivity for alpha-smooth muscle actin [35,36].…”