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[Case with cardiac myxoma causing cerebral metastasis after cardiac tumor resection]
Ryusuke Suzuki1, T Watanabe, R Hirayama
1Department of Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.
Insights
Cardiac myxoma can metastasize to the brain even after surgical resection. This case highlights the importance of monitoring for delayed cerebral metastases from cardiac myxoma.
Area of Science:
- Cardiology
- Neurology
- Oncology
Background:
- Cardiac myxomas are primary heart tumors, most commonly found in the left atrium.
- While generally benign, cardiac myxomas can cause embolic events, leading to neurological complications.
- This case explores a rare instance of delayed cerebral metastasis from a cardiac myxoma post-resection.
Observation:
- A 68-year-old male presented with cerebral infarction, revealing a left atrial cardiac myxoma via echocardiography.
- The cardiac tumor was surgically resected, with an initially uneventful postoperative recovery.
- Six months later, the patient developed headaches, and brain CT identified multiple metastatic lesions.
Findings:
- Pathological diagnosis confirmed the brain tumors as metastases of the original cardiac myxoma.
- The patient received 40.8 Gy of whole-brain radiation therapy for the brain metastases.
- Radiation therapy proved effective in treating and reducing the size of the brain metastases.
Implications:
- This case underscores the potential for late-onset cerebral metastasis from cardiac myxoma, even after successful tumor removal.
- It emphasizes the need for long-term neurological surveillance in patients with a history of cardiac myxoma.
- Early detection and multimodal treatment, including radiation therapy, are crucial for managing cardiac myxoma brain metastases.
Abstract:
We report a case of cardiac myxoma causing cerebral metastasis after cardiac tumor resection. A 68-year-old man with a cerebral infarction was admitted to our hospital. A cardioembolic source was suspected and echocardiography was performed. In that examination, a cardiac tumor was found in the left atrium. Tumor resection was performed urgently and his postoperative course was uneventful. After the operation he had no new episodes of cerebral deficit. However 6 months after the operation, he complained of headaches. The brain computed tomography (CT) showed there were multiple high-density areas. One of the tumors was resected and the tumor was diagnosed pathologically as metastasis of cardiac myxoma. Brain metastases were treated with 40.8 Gy whole-brain radiation therapy. As the result the tumors were effectively treated and reduced.