gms | German Medical Science

76th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

04.05. - 08.05.2005, Erfurt

Proliferative Myositis: a rare differential diagnosis for an ENT-tumor: a case report

Meeting Abstract

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  • corresponding author Claudius Fauser - Klinik of the Technical University of Munich, Munich
  • author Hans Peter Niedermeyer - Klinik of the Technical University of Munich, Munich
  • Jörg Nährig - Klinik of the Technical University of Munich, Munich

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno245

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2005/05hno112.shtml

Published: September 22, 2005

© 2005 Fauser et al.
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Outline

Text

Proliferative myositis is a rare, neoplastic condition of the skeletal muscle. This condition is predominantly found in the shoulder and arm muscles, whereas occurrence in the head and neck region is a rarity. We report on a 64 year old female who presented with a hard, painless induration on her right neck. Within a couple of days, four centimeters of the sternocleidoid muscle swelled up with no obvious cause. Sonogram and CT scans demonstrated a diffuse, well perfused tissue proliferation within the muscle, with no enlargement of the local lymph nodes. Additionally, examination of a blood sample showed no signs of inflammation. A biopsy was performed, as the lesion continued to grow in spite of antibiotic and anti-inflammatory treatment. The operation showed that both the muscle and the surrounding tissue were diffusely infiltrated. Histological examination revealed the characteristic picture of a proliferative myositis: extensive proliferation of basophilic, ganglion-like giant epitheloid cells in a “checkerboard” like pattern. There were no signs of specificity or malignancy. The entire lesion was excised (not radically, R2) and the accessory nerve and the clavicular head of the sternocleidoid muscle were preserved. Six months after the operation the patient is without complications or signs of recurrence. Proliferative myositis is a self-limiting neoplastic proliferation, which can be treated conservatively. There are a number of reports on spontaneous recovery. Proliferative myositis should be taken into account if a rapidly growing, intramuscular tumor occurs in the head and neck region. The diagnosis can only be made by the pathologist and a biopsy is mandatory.