Atrial myxoma with cerebellar signs: a case report

Abstract

Background: Atrial myxoma remains a rare clinical entity with an incidence of surgically resected cases of 0.5-0.7 per million population and prevalence of < 5 per 10,000. It typically manifests in woman after third decade of life; symptoms vary greatly and may present with arrhythmia, intracardiac flow obstruction, embolic phenomenon, and associated constitutional symptoms. Neurological complications associated with atrial myxoma most frequently include cerebral infarct due to embolus. Cerebellar involvement is very rare and only a few cases have been reported in the literature. Case presentation: A 55-year-old Brahmin man with no history of diabetes mellitus and hypertension, presented with complaints of dizziness, headache, vomiting, double vision, and unsteadiness of gait for 2 weeks. His headache was sudden in onset, of a pulsating type and localized on left temporal side. Vomiting was projectile and bilious. Double vision was present in all directions of gaze and he had uncoordinated movement of his body and tilting to the left side. On examination, his cerebellar functions were impaired. He was thoroughly investigated for the cause of stroke after abnormal magnetic resonance imaging results with normal computed tomography angiography of his brain. Echocardiography and computed tomography of his chest showed a mass attached to intra-atrial septum and prolapsing through mitral valve, which was suggestive of left atrial myxoma. Five days following admission, he developed abdominal pain due to thromboembolism causing splenic and renal infarct. Conclusion: Although rare, atrial myxoma has to be considered a cause of stroke and other embolic phenomenon causing multiorgan infarctions. Early and timely diagnosis of the condition can prevent further recurrence and inappropriate anticoagulant therapy. It would be pertinent to have echocardiography done in patients who present with a stroke, arrhythmias, and other constitutional symptoms. The tumor once detected must be removed surgically as early as possible, which not only reduces serious thromboembolic complications but can be potentially curative.

A case report of left atrial myxoma presenting with amnesia

“…Cardiac tumors are rare in medical cases. Primary cardiac tumors are included in approximately 5% of cardiac tumors, and their occurrence are estimated to be less than 0.03% [ 1 ]. Approximately 90% of primary cardiac tumors are benign.…”

“…They generally occur more in females and after the third decade of life [ 4 ]. The tumor can cause the atrio-ventricular valve obstruction as well as the embolization phenomenon by throwing clots into systemic and pulmonary circulation [ 1 , 5 ]. Systemic embolization occurs in 30–40% of cases of atrial myxoma [ 6 ].…”

“…Systemic embolization occurs in 30–40% of cases of atrial myxoma [ 6 ]. Neurological manifestation and stroke are the most serious charges, and arrhythmia, heart failure and pericardial effusion are cardiac manifestations [ 1 ].…”

Peripheral arterial embolism in a patient with left atrial myxoma: a case report

“…Миксома -это первичная внутриполостная, гистологически доброкачественная опухоль сердца, которая может быть злокачественной по клиническому течению; это связано с частым развитием таких осложнений как эмболии, недостаточность кровообращения, внезапная сердечная смерть. Первичные опухоли сердца являются редкой нозологией и, согласно статистическим данным, составляют 0,001-0,03% в структуре кардиальной патологии [1,2].…”

“…Средний возраст обнаружения миксом колеблется в пределах 30-60 лет, хотя описаны случаи этого заболевания во всех возрастных категориях. Соотношение мужчин и женщин составляет 3:1 [2].…”