Perplexing imaging manifestations of multiple metastatic intracranial lesions associated with atrial myxoma

Neurological manifestations of atrial myxomas may be encountered in different pathological circumstances: cerebral embolism, intracranial aneurysms, and metastatic mass lesions. We report a case of multiple metastatic intracranial lesions associated with atrial myxoma and discuss the potential mechanisms of its perplexing neuroimaging manifestations. Comparing with previous reports of myxoma-associated intracranial lesions, the most notable features of the present case were the multiple high-density "calcified" lesions accompanying the aneurysms on computed tomography scan and the significant contrast-enhanced mass in the left parietal lobe on magnetic resonance scan. This suggested an extremely rare case of coexistence of aneurysms and intracranial metastatic mass lesion associated with cardiac myxoma, although the pathological evidence was not available.