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Small, smooth, nonmobile cardiac myxoma detected by transesophageal echocardiography following recurrent cerebral infarction: a case report

BACKGROUND: Cardiac myxoma is known to cause repeated events of cerebral embolism. Soft and irregularly shaped myxomas with high mobility are associated with a higher occurrence of cerebral embolism. In contrast, nonmobile cardiac myxomas with a round regular shape are rarely considered to be a caus...

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Autores principales: Saito, Yuki, Aizawa, Yoshihiro, Monno, Koyuru, Nagashima, Koichi, Kurokawa, Sayaka, Osaka, Shunji, Akimoto, Takayoshi, Kamei, Satoshi, Tanaka, Masashi, Hirayama, Atsushi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5424306/
https://www.ncbi.nlm.nih.gov/pubmed/28486992
http://dx.doi.org/10.1186/s13256-017-1298-z
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author Saito, Yuki
Aizawa, Yoshihiro
Monno, Koyuru
Nagashima, Koichi
Kurokawa, Sayaka
Osaka, Shunji
Akimoto, Takayoshi
Kamei, Satoshi
Tanaka, Masashi
Hirayama, Atsushi
author_facet Saito, Yuki
Aizawa, Yoshihiro
Monno, Koyuru
Nagashima, Koichi
Kurokawa, Sayaka
Osaka, Shunji
Akimoto, Takayoshi
Kamei, Satoshi
Tanaka, Masashi
Hirayama, Atsushi
author_sort Saito, Yuki
collection PubMed
description BACKGROUND: Cardiac myxoma is known to cause repeated events of cerebral embolism. Soft and irregularly shaped myxomas with high mobility are associated with a higher occurrence of cerebral embolism. In contrast, nonmobile cardiac myxomas with a round regular shape are rarely considered to be a cause of cerebral embolism. In this case, we present a patient with recurrent cerebral embolism associated with a small and nonmobile cardiac myxoma of round regular shape. CASE PRESENTATION: A 76-year-old Japanese man presented to our hospital with weakness in his right upper extremity. He had a history of right frontal lobe infarction in the previous month. T2-weighted magnetic resonance imaging revealed an area of hyperintensity in the left precentral gyrus, indicating acute cerebral infarction. Transthoracic echocardiography revealed normal left ventricular function and no abnormalities. However, transesophageal echocardiography showed a small and nonmobile left atrial tumor with round regular shape attached to the ostium secundum of the atrial septum. Based on these findings, we diagnosed recurrent cerebral infarction due to embolization caused by left atrial myxoma, and cardiac tumor extraction was performed on hospitalization day 36. The excised tumor measured 0.6 × 0.6 × 0.5 cm and was diagnosed as cardiac myxoma by histologic examination. CONCLUSIONS: Even small and nonmobile cardiac myxomas with a round regular shape may cause recurrent cerebral infarction. The diagnosis of this type of atrial myxoma is elusive and transesophageal echocardiography was an effective method of detection. In a clinical situation, this type of cardiac myxoma may be overlooked as a cause of cerebral infarction.
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spelling pubmed-54243062017-05-10 Small, smooth, nonmobile cardiac myxoma detected by transesophageal echocardiography following recurrent cerebral infarction: a case report Saito, Yuki Aizawa, Yoshihiro Monno, Koyuru Nagashima, Koichi Kurokawa, Sayaka Osaka, Shunji Akimoto, Takayoshi Kamei, Satoshi Tanaka, Masashi Hirayama, Atsushi J Med Case Rep Case Report BACKGROUND: Cardiac myxoma is known to cause repeated events of cerebral embolism. Soft and irregularly shaped myxomas with high mobility are associated with a higher occurrence of cerebral embolism. In contrast, nonmobile cardiac myxomas with a round regular shape are rarely considered to be a cause of cerebral embolism. In this case, we present a patient with recurrent cerebral embolism associated with a small and nonmobile cardiac myxoma of round regular shape. CASE PRESENTATION: A 76-year-old Japanese man presented to our hospital with weakness in his right upper extremity. He had a history of right frontal lobe infarction in the previous month. T2-weighted magnetic resonance imaging revealed an area of hyperintensity in the left precentral gyrus, indicating acute cerebral infarction. Transthoracic echocardiography revealed normal left ventricular function and no abnormalities. However, transesophageal echocardiography showed a small and nonmobile left atrial tumor with round regular shape attached to the ostium secundum of the atrial septum. Based on these findings, we diagnosed recurrent cerebral infarction due to embolization caused by left atrial myxoma, and cardiac tumor extraction was performed on hospitalization day 36. The excised tumor measured 0.6 × 0.6 × 0.5 cm and was diagnosed as cardiac myxoma by histologic examination. CONCLUSIONS: Even small and nonmobile cardiac myxomas with a round regular shape may cause recurrent cerebral infarction. The diagnosis of this type of atrial myxoma is elusive and transesophageal echocardiography was an effective method of detection. In a clinical situation, this type of cardiac myxoma may be overlooked as a cause of cerebral infarction. BioMed Central 2017-05-10 /pmc/articles/PMC5424306/ /pubmed/28486992 http://dx.doi.org/10.1186/s13256-017-1298-z Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Saito, Yuki
Aizawa, Yoshihiro
Monno, Koyuru
Nagashima, Koichi
Kurokawa, Sayaka
Osaka, Shunji
Akimoto, Takayoshi
Kamei, Satoshi
Tanaka, Masashi
Hirayama, Atsushi
Small, smooth, nonmobile cardiac myxoma detected by transesophageal echocardiography following recurrent cerebral infarction: a case report
title Small, smooth, nonmobile cardiac myxoma detected by transesophageal echocardiography following recurrent cerebral infarction: a case report
title_full Small, smooth, nonmobile cardiac myxoma detected by transesophageal echocardiography following recurrent cerebral infarction: a case report
title_fullStr Small, smooth, nonmobile cardiac myxoma detected by transesophageal echocardiography following recurrent cerebral infarction: a case report
title_full_unstemmed Small, smooth, nonmobile cardiac myxoma detected by transesophageal echocardiography following recurrent cerebral infarction: a case report
title_short Small, smooth, nonmobile cardiac myxoma detected by transesophageal echocardiography following recurrent cerebral infarction: a case report
title_sort small, smooth, nonmobile cardiac myxoma detected by transesophageal echocardiography following recurrent cerebral infarction: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5424306/
https://www.ncbi.nlm.nih.gov/pubmed/28486992
http://dx.doi.org/10.1186/s13256-017-1298-z
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