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Delayed cerebral metastasis after complete resection of left atrial cardiac myxoma: a case report
Shogo Narikiyo1, Toru Yasutsune1, Masayoshi Umesue1
1Department of Cardiovascular Surgery, Matsuyama Red Cross Hospital, 1 Bunkyo-cho, Matsuyama, Ehime 790-8524, Japan.
Insights
Cardiac myxoma, a common benign heart tumor, can rarely metastasize to the brain years after surgical removal. This case highlights the need for ongoing neurological surveillance in patients with cardiac myxoma.
Area of Science:
- Cardiology
- Neurology
- Oncology
Background:
- Cardiac myxoma (CM) is the most frequent primary cardiac tumor, typically curable via surgical excision.
- Systemic embolization is a known complication of CM, but delayed cerebral metastasis is exceptionally rare.
Abstract:
Cardiac myxoma (CM) is the most common benign primary cardiac tumor and is usually curable with complete surgical excision. However, CM can cause systemic embolization, and delayed cerebral metastasis is extremely rare. A 54-year-old woman presented with progressive lower limb weakness and was diagnosed with multiple cerebral infarctions associated with a left atrial pedunculated tumor. The tumor was completely resected under cardiopulmonary bypass and confirmed histopathologically as CM. Seven months later, she developed transient visual disturbances and right-hand weakness. Brain magnetic resonance imaging revealed enlarging lesions inconsistent with vascular territories. Craniotomy and histopathology with calretinin positivity confirmed metastatic myxoma. She underwent stereotactic radiotherapy and remained recurrence-free at 1 year. Even after complete resection of CM, delayed cerebral metastasis may occur. Persistent neurological surveillance and multidisciplinary management are essential for early detection and favorable long-term outcomes in patients with CM.
