Early and delayed neurological manifestations of cardiac myxomas

Clin Neurol Neurosurg. 2020 Mar:190:105673. doi: 10.1016/j.clineuro.2020.105673. Epub 2020 Jan 7.

Abstract

Cardiac myxoma can embolize and cause early and delayed sequelae including stroke, growth into intracranial fusiform aneurysms and cerebral tumors with risk of hemorrhage and mass effect. Here, we report the rare coincidence of all these manifestations in a 63-year-old man who presented with cognitive and behavioral changes, and seizures 9 months after an embolic stroke from the heart tumor. C-reactive protein (CRP) was elevated at the time of stroke and cardiac myxoma diagnosis but was normal at late neurologic manifestation with isolated myxoma-related intracranial tumors and aneurysms. Low-dose whole-brain radiotherapy can be helpful to diminish cerebral myxoma tumors and fusiform aneurysms despite reported increased risk of aneurysm rupture.

Keywords: CRP; Fusiform aneurysm; Myxoma; Radiotherapy; Stellate cells.

Publication types

  • Case Reports

MeSH terms

  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / etiology*
  • Brain Neoplasms / pathology
  • C-Reactive Protein / metabolism
  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Hemorrhage / etiology
  • Embolic Stroke / diagnostic imaging
  • Embolic Stroke / etiology*
  • Heart Neoplasms / complications*
  • Heart Neoplasms / metabolism
  • Heart Neoplasms / pathology
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / etiology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Myxoma / complications*
  • Myxoma / diagnostic imaging
  • Myxoma / metabolism
  • Myxoma / pathology
  • Neoplastic Cells, Circulating / pathology*

Substances

  • C-Reactive Protein