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[An autopsy case of cerebral embolism caused by atrial myxoma]
S Matsuoka1, M Ito, T Shinonome
1Department of Neurosurgery, Municipal Central Hospital.
Insights
Cardiac myxoma, a rare heart tumor, can cause sudden stroke in young individuals. This case highlights the importance of considering cardiac myxoma in the differential diagnosis of unexplained neurological events.
Area of Science:
- Cardiology
- Neurology
- Pathology
Background:
- Cardiac myxoma is a rare primary cardiac tumor, often benign, but can lead to serious embolic complications.
- Systemic embolization from cardiac myxoma can affect various organs, including the brain, leading to stroke.
Observation:
- A 14-year-old female presented with sudden onset of altered consciousness and right hemiplegia during athletic activity.
- Initial CT scans were unremarkable, but cerebral angiography revealed embolic stenosis of the left middle cerebral artery.
Findings:
- Autopsy revealed systemic embolization of cardiac myxoma, with evidence in the brain (left middle cerebral artery), spleen, kidneys, liver, and pancreas.
- Histological examination confirmed myxoma emboli as the cause of arterial obstructions, including bilateral common iliac artery occlusion.
Implications:
- Left atrial myxoma, though rare, is a critical, potentially treatable cause of stroke, particularly in younger populations.
- This case underscores the necessity of including cardiac myxoma in the differential diagnosis for young patients presenting with cerebrovascular disease.
Abstract:
We reported an autopsy case of a 14-year-old girl with cardiac myxoma, presenting sudden onset of consciousness disturbance and right hemiplegia while running in an 800 meter race. Though CT scan showed no abnormal findings, cerebral angiogram revealed an embolic stenosis of the left middle cerebral artery, and abdominal aortogram showed complete obstruction of the bilateral common iliac artery. Histological study of emboli taken from obstructed femoral arteries showed systemic embolization of the cardiac myxoma. She died three days after admission. Autopsy was performed. Myxoma tissue was not found, but its stalk was left in the left atrial septum. The brain was very edematous, and a myxoma emboli was found in the left middle cerebral artery. Systemic embolization of myxoma to spleen, kidneys, liver, pancreas, etc. was found histologically. Left atrial myxoma is a rare but potentially treatable cause of stroke, and should be included in the differential diagnosis of cerebral vascular disease, especially in young patients.