تقرير
Multiple craniotomies for the resection of symptomatic multifocal intracranial metastatic cardiac myxoma: A case report.
| العنوان: | Multiple craniotomies for the resection of symptomatic multifocal intracranial metastatic cardiac myxoma: A case report. |
|---|---|
| المؤلفون: | Abdow Iii VP; School of Medicine, Georgetown University, Washington, DC, United States., Breton JM; Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC, United States., Nayar VV; Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC, United States. |
| المصدر: | Surgical neurology international [Surg Neurol Int] 2023 Sep 08; Vol. 14, pp. 322. Date of Electronic Publication: 2023 Sep 08 (Print Publication: 2023). |
| نوع المنشور: | Case Reports |
| اللغة: | English |
| بيانات الدورية: | Publisher: Scientific Scholar LLC Country of Publication: United States NLM ID: 101535836 Publication Model: eCollection Cited Medium: Print ISSN: 2229-5097 (Print) Linking ISSN: 21527806 NLM ISO Abbreviation: Surg Neurol Int Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Publication: Pittsford, NY, USA : Scientific Scholar LLC Original Publication: Mumbai : Medknow |
| مستخلص: | Background: Myxomas, rare benign mesenchymal lesions, are the most common cardiac tumors. Patients may rarely develop hematogenous metastasis to the brain, which can present as new-onset neurological deficits that correlate with multifocal hemorrhagic lesions on imaging. Limited guidelines presently exist for the treatment of such lesions. This report outlines a unique case involving three craniotomies and failed radiation therapy in the treatment of metastatic cardiac myxoma. Case Description: A 63-year-old woman presented with a right middle cerebral artery embolic stroke secondary to a left atrial myxoma and multifocal hemorrhagic lesions consistent with intracranial metastasis. She had a right frontal craniotomy for tumor resection, followed by stereotactic radiosurgery, though this did not arrest disease progression. She later had a left occipital craniotomy for a symptomatic lesion. More than two years after her initial presentation, she returned with acute-onset symptoms correlating to growth in a left frontal lesion requiring another resection. Following this third craniotomy, imaging has not revealed the progression of metastatic intracranial disease. She is pursuing further treatment through primary cardiac tumor resection. Conclusion: Although rare, hematogenous seeding with subsequent formation of hemorrhagic metastasis is a possible complication of atrial myxoma. While surgical resection, radiation therapy, and chemotherapy have historically been used, no standard of care currently exists. This case demonstrates repeat tumor resection as effective for managing symptomatic intracranial metastatic myxoma in a patient with poor response to radiation therapy and multiple recurrences, with follow-up showing improvement in neurological symptoms and mass effect and absence of recurrence on imaging. Competing Interests: There are no conflicts of interest. (Copyright: © 2023 Surgical Neurology International.) |
| References: | Neuropathology. 2020 Jun;40(3):295-301. (PMID: 32232866) Front Neurol. 2023 Feb 08;13:1046441. (PMID: 36845225) BMC Neurol. 2019 Oct 23;19(1):249. (PMID: 31646971) J Neurol Surg Rep. 2020 Jan;81(1):e1-e6. (PMID: 32051810) Can J Neurol Sci. 2015 Nov;42(6):457-60. (PMID: 26446755) |
| فهرسة مساهمة: | Keywords: Case report; Craniotomy; Metastatic myxoma; Recurrent myxoma |
| تواريخ الأحداث: | Date Created: 20231009 Latest Revision: 20231018 |
| رمز التحديث: | 20240829 |
| مُعرف محوري في PubMed: | PMC10559549 |
| DOI: | 10.25259/SNI_593_2023 |
| PMID: | 37810324 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2229-5097 |
|---|---|
| DOI: | 10.25259/SNI_593_2023 |