Solís-Gómez Raymundo, Dávalos Cabral Natalia, Arrieta Limón Gerardo, Hurtado Presa Brandon Alberto, Salgado Alvear Andrea, Reyes Martínez Laura Michelle, Serrano Arias Fabiola Eunice
Instituto Nacional de Neurología y Neurocirugía.
Rev Fac Cien Med Univ Nac Cordoba. 2024 Dec 13;81(4):783-792. doi: 10.31053/1853.0605.v81.n4.44662.
Cardiac myxomas are the most common benign neoplasms of the heart, mainly located in the left atrium. The preferred treatment is the resection of the myxoma. This method not only prevents complications but also has a low recurrence rate. Brain metastases usually occur when tumor fragments embolize and implant at the destination place.
We report the case of a patient with multiple brain metastases, found during follow-up, after the presentation of stroke. This case stands out because the embolization causing the brain metastasis might have occurred either during the ischemic stroke or when the cardiac myxoma was being removed. In our case, the patient was evaluated during follow-up with brain magnetic resonance imaging, finding multiple metastatic lesions. To determine the type of lesion, a biopsy was performed and the histological diagnosis, which was indicative of metastatic tissue of left atrial myxoma.
Patients with cardioembolism should undergo a complete diagnostic protocol to distinguish the cause of embolization, whether it is a blood clot or a tumor embolus. The treatment of choice is the resection of the myxoma, which cures the primary neurological symptoms and prevents neurological complications. However, it is essential to maintain active surveillance for a longer time for the detection and appropriate treatment of brain metastases.
心脏黏液瘤是最常见的心脏良性肿瘤，主要位于左心房。首选的治疗方法是切除黏液瘤。这种方法不仅能预防并发症，而且复发率低。脑转移通常发生在肿瘤碎片栓塞并植入到目的地时。
我们报告了一例患者，在出现中风后随访期间发现有多发性脑转移。该病例的突出之处在于，导致脑转移的栓塞可能发生在缺血性中风期间，也可能发生在切除心脏黏液瘤时。在我们的病例中，患者在随访期间接受了脑部磁共振成像检查，发现了多个转移病灶。为了确定病变类型，进行了活检，组织学诊断表明为左心房黏液瘤的转移组织。
患有心源性栓塞的患者应接受完整的诊断方案，以区分栓塞的原因，无论是血凝块还是肿瘤栓子。首选的治疗方法是切除黏液瘤，这可以治愈原发性神经症状并预防神经并发症。然而，必须进行更长时间的积极监测，以检测和适当治疗脑转移。
