Infra-Auricular Subcutaneous Myxoma: Surgical Challenges and Histopathological Insights

Myxomas are rare, benign mesenchymal tumors predominantly found in connective tissues, rarely occurring in the head and neck. Composed of stellate cells in a mucoid matrix, their incidence in intramuscular locations is about 1 in 1,000,000, with fewer than 200 cases reported since 1948. This report discusses the surgical treatment and pathology of a subcutaneous myxoma in the infraauricular region.

A middle-aged male presented with a painful, discharging polypoidal mass in the infraauricular area, initially misdiagnosed as a dermoid cyst from imaging and biopsy. Surgical excision and reconstruction using a bilobed flap were performed. Histopathological analysis confirmed myxoma. At the six-month follow-up, the patient demonstrated excellent wound healing and functional recovery, emphasizing the effectiveness of the bilobed flap in infraauricular reconstruction.

This case highlights the diagnostic challenge of myxomas, especially in unusual locations. Effective management relies on surgical removal with histological confirmation, demonstrating the importance of considering myxomas in differential diagnoses of neck masses. The successful use of a bilobed flap for reconstruction emphasizes the necessity for appropriate surgical planning to manage aesthetic and functional outcomes.