Non-small cell lung cancer with concomitant intramuscular myxoma of the right psoas mimicking intramuscular metastasis: 
A case report and literature review

Zhang,Peng; Meng,Xue; Xia,Lianke; Xie,Peng; Sun,Xindong; Gao,Yongsheng; Wang,Shijiang; Zhao,Xianguang; Yu,Jinming

doi:10.3892/ol.2015.3704

November-2015 Volume 10 Issue 5

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

November-2015 Volume 10 Issue 5

Full Size Image

Case Report

Non-small cell lung cancer with concomitant intramuscular myxoma of the right psoas mimicking intramuscular metastasis: A case report and literature review

Authors:
- Peng Zhang
- Xue Meng
- Lianke Xia
- Peng Xie
- Xindong Sun
- Yongsheng Gao
- Shijiang Wang
- Xianguang Zhao
- Jinming Yu
View Affiliations / Copyright

Affiliations: Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, P.R. China, Department of Orthopedics, Shouguang City People's Hospital, Weifang, Shandong, P.R. China, Department of Pathology, Shandong Cancer Hospital and Institute, Jinan, Shandong, P.R. China
Pages: 3059-3063
|
Published online on: September 15, 2015

https://doi.org/10.3892/ol.2015.3704
Expand metrics +

Abstract

Intramuscular myxoma (IMM) as a rare soft-tissue tumor arising from the muscles is completely benign. When IMM accompanies malignance, it may be misdiagnosed as muscle metastasis, and for this extremely rare concurrence, the subsequent treatment would vary accordingly. The current study presents, to the best of our knowledge, the first case of non‑small cell lung cancer (NSCLC) concomitant with IMM mimicking skeletal muscle metastasis. A 64‑year‑old female was hospitalized with a history of chest discomfort and right lumbar pain that had persisted for four months. The computed tomography scan showed a lesion in the left upper lobe of the lung and the right psoas, respectively. Serum biomarkers for NSCLC were abnormal. A presumptive clinical diagnosis was compatible with left NSCLC and right psoas muscle metastasis (cT2aN3M1b, stage Ⅳ). Stage Ⅳ lung cancer would receive palliative treatment. However, the final diagnosis of synchronous left lung squamous cell carcinoma (cT2aN3M0, stage ⅢB) and IMM in the right psoas was confirmed by biopsy. The patient therefore underwent definitive chemoradiotherapy for lung carcinoma, and conservative treatment, including analgesics, for IMM. The diagnosis process for a malignant neoplasm concomitant with IMM is not straightforward due to a lack of clinical experience, and it significantly affects the tumor staging and subsequent treatment strategy. The present case suggests that IMM should be included in the differential diagnosis when an abnormal intramuscular lesion concomitant with malignancy is identified. The value of histopathological diagnosis prior to definitive treatment also requires highlighting.

View Figures

View References

1	Stout AP: Myxoma, the tumor of primitive mesenchyme. Ann Surg. 127:706–719. 1948. View Article : Google Scholar : PubMed/NCBI
2	Allen PW: Myxoma is not a single entity: A review of the concept of myxoma. Ann Diagn Pathol. 4:99–123. 2000. View Article : Google Scholar : PubMed/NCBI
3	Heymans O, Gebhart M, Alexiou J, de Saint Aubain N and Larsimont D: Intramuscular myxoma. Acta Chir Belg. 98:120–122. 1998.PubMed/NCBI
4	Enzinger FM: Intramuscular myxoma; A review and follow-up study of 34 cases. Am J Clin Pathol. 43:104–113. 1965.PubMed/NCBI
5	Charron P and Smith J: Intramuscular myxomas: A clinicopathologic study with emphasis on surgical management. Am Surg. 70:1073–1077. 2004.PubMed/NCBI
6	Siegel R, Ma J, Zou Z and Jemal A: Cancer statistics, 2014. CA Cancer J Clin. 64:9–29. 2014. View Article : Google Scholar : PubMed/NCBI
7	Kwas HH, Zendah I and Ghedira H: Skeletal muscle metastases from lung cancer. Asian Cardiovasc Thorac Ann. 21:741–743. 2013. View Article : Google Scholar : PubMed/NCBI
8	Pop D, Nadeemy AS, Venissac N, Guiraudet P, Otto J, Poudenx M and Mouroux J: Skeletal muscle metastasis from non-small cell lung cancer. J Thorac Oncol. 4:1236–1241. 2009. View Article : Google Scholar : PubMed/NCBI
9	Falavigna A, Righesso O, Volquind D and Teles AR: Intramuscular myxoma of the cervical paraspinal muscle. Eur Spine J. 18:245–249. 2009. View Article : Google Scholar : PubMed/NCBI
10	Ripalda E, Beni R, Reguero ME, Nistal J and Carda P: Recurrent Intramuscular Psoas Myxoma. Am Surg. 75:862–863. 2009.PubMed/NCBI
11	Goldstraw P, Crowley J, Chansky K, Giroux DJ, Groome PA, Rami-Porta R, Postmus PE, Rusch V and Sobin L: International Association for the Study of Lung Cancer International Staging Committee; Participating Institutions: The IASLC Lung Cancer Staging Project: Proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol. 2:706–714. 2007. View Article : Google Scholar : PubMed/NCBI
12	Aupérin A, Le Péchoux C, Rolland E, Curran WJ, Furuse K, Fournel P, Belderbos J, Clamon G, Ulutin HC and Paulus R: Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer. J Clin Oncol. 28:2181–2190. 2010. View Article : Google Scholar : PubMed/NCBI
13	Sudo A, Ogihara Y, Shiokawa Y, Fujinami S and Sekiguchi S: Intramuscular metastasis of carcinoma. Clin Orthop Relat Res. 296:213–217. 1993.PubMed/NCBI
14	Ruiz-Tovar J, Ripalda E, Beni R, Reguero ME, Nistal J and Carda P: Recurrent intramuscular psoas myxoma. Am Surg. 75:862–863. 2009.PubMed/NCBI
15	Damron TA and Heiner J: Distant soft tissue metastases: A series of 30 new patients and 91 cases from the literature. Ann Surg Oncol. 7:526–534. 2000. View Article : Google Scholar : PubMed/NCBI
16	Quint LE, Tummala S, Brisson LJ, Francis IR, Krupnick AS, Kazerooni EA, Iannettoni MD, Whyte RI and Orringer MB: Distribution of distant metastases from newly diagnosed non-small cell lung cancer. Ann Thorac Surg. 62:246–250. 1996. View Article : Google Scholar : PubMed/NCBI
17	Ampil FL, Lall C and Datta R: Palliative management of metastatic tumors involving the psoas muscle: Case reports and review of the literature. Am J Clin Oncol. 24:313–314. 2001. View Article : Google Scholar : PubMed/NCBI
18	Strauss JB, Shah AP, Chen SS, Gielda BT and Kim AW: Psoas muscle metastases in non-small cell lung cancer. J Thorac Dis. 4:83–87. 2012.PubMed/NCBI
19	Plaza JA, Perez-Montiel D, Mayerson J, Morrison C and Suster S: Metastases to soft tissue: A review of 118 cases over a 30-year period. Cancer. 112:193–203. 2008. View Article : Google Scholar : PubMed/NCBI
20	Murphey MD, McRae GA, Fanburg-Smith JC, Temple HT, Levine AM and Aboulafia AJ: Imaging of soft-tissue myxoma with emphasis on CT and MR and comparison of radiologic and pathologic findings. Radiology. 225:215–224. 2002. View Article : Google Scholar : PubMed/NCBI
21	Bancroft LW, Kransdorf MJ, Menke DM, O'Connor MI and Foster WC: Intramuscular myxoma: Characteristic MR imaging features. AJR Am J Roentgenol. 178:1255–1259. 2002. View Article : Google Scholar : PubMed/NCBI
22	Tassart M, Roussy M, Boidart F and Tricot JF: Muscular myxoma. A case of myxoma of the psoas. J Radiol. 74:147–150. 1993.PubMed/NCBI
23	van Roggen JF, McMenamin ME and Fletcher CD: Cellular myxoma of soft tissue: A clinicopathological study of 38 cases confirming indolent clinical behaviour. Histopathology. 39:287–297. 2001. View Article : Google Scholar : PubMed/NCBI
24	Dormand EL, Prabhu-Desai A, Rice AJ and Rosin RD: Not all pain in the left iliac fossa is diverticular disease: A case study of a psoas myxoma and review. Surgeon. 4:239–243. 2006. View Article : Google Scholar : PubMed/NCBI
25	Haraguchi N, Yamamoto Y, Sasaki K, Satoh H and Sekizawa K: Muscle metastases as initial manifestation of lung cancer. Clin Oncol (R Coll Radiol). 16:586–587. 2004. View Article : Google Scholar : PubMed/NCBI
26	Pretorius ES and Fishman EK: Helical CT of skeletal muscle metastases from primary carcinomas. AJR Am J Roentgenol. 174:401–404. 2000. View Article : Google Scholar : PubMed/NCBI
27	Williams JB, Youngberg RA, Bui-Mansfield LT and Pitcher JD: MR imaging of skeletal muscle metastases. AJR Am J Roentgenol. 168:555–557. 1997. View Article : Google Scholar : PubMed/NCBI
28	Yang WT, Yeo W and Metreweli C: Imaging of iliopsoas metastasis. Clin Radiol. 54:85–89. 1999. View Article : Google Scholar : PubMed/NCBI
29	Stewart IC, Blaikie KJ and MacLeod HM: Adenocarcinoma of unknown primary site (ACUPS) presenting as a psoas abscess. Scott Med J. 34:4701989.PubMed/NCBI
30	Ozawa H, Fujii M, Tomita T and Ogawa K: Intramuscular myxoma of scalene muscle: A case report. Auris Nasus Larynx. 31:319–322. 2004. View Article : Google Scholar : PubMed/NCBI
31	Molina-Garrido MJ and Guillén-Ponce C: Muscle metastasis of carcinoma. Clin Transl Oncol. 13:98–101. 2011. View Article : Google Scholar : PubMed/NCBI
32	Al-Alao BS, Westrup J and Shuhaibar MN: Non-small-cell lung cancer: Unusual presentation in the gluteal muscle. Gen Thorac Cardiovasc Surg. 59:382–384. 2011. View Article : Google Scholar : PubMed/NCBI
33	McKeown PP, Conant P and Auerbach LE: Squamous cell carcinoma of the lung: An unusual metastasis to pectoralis muscle. Ann Thorac Surg. 61:1525–1526. 1996. View Article : Google Scholar : PubMed/NCBI
34	Charron P and Smith J: Intramuscular myxomas: A clinicopathologic study with emphasis on surgical management. Am Surg. 70:1073–1077. 2004.PubMed/NCBI