Basu Anna, Grindrod Natalie, Dar A Rashid, Leung Andrew, Cecchini Matt, Lock Michael
London Health Sciences Centre, Schulich School of Medicine, Western University, London, ON, Canada.
Radiat Oncol J. 2024 Dec;42(4):330-334. doi: 10.3857/roj.2024.00395. Epub 2024 Dec 20.
Cardiac myxomas, the most common primary cardiac tumors, are believed to originate from multipotent mesenchymal cells. Approximately 75% of myxomas occur within the left atrium, increasing the risk of systemic thromboembolic events. While typically benign, atrial myxomas can rarely metastasize to the brain, with fewer than 60 cases reported. We present a case of a 56-year-old woman with a history of left atrial myxoma who developed headaches, right arm weakness, and blurry vision three months post-cardiac surgery. Imaging showed multiple hemorrhagic brain lesions, and she was treated with whole brain radiotherapy (20 Gy/5 fractions). Four years later, she remains stable with no new lesions and has fully regained function. Currently, there is no standard management for cardiac myxoma metastases. This case highlights the potential role of radiotherapy in managing brain metastases from left atrial myxomas, suggesting a possible treatment strategy based on this case and a review of the literature.
心脏黏液瘤是最常见的原发性心脏肿瘤，被认为起源于多能间充质细胞。约75%的黏液瘤发生于左心房，增加了全身血栓栓塞事件的风险。虽然通常为良性，但心房黏液瘤很少会转移至脑，报告的病例少于60例。我们报告一例56岁女性，有左心房黏液瘤病史，心脏手术后三个月出现头痛、右臂无力和视力模糊。影像学检查显示多发性出血性脑病变，她接受了全脑放射治疗（20 Gy/5次分割）。四年后，她病情稳定，无新病变，功能已完全恢复。目前，对于心脏黏液瘤转移尚无标准的治疗方法。该病例突出了放射治疗在处理左心房黏液瘤脑转移中的潜在作用，基于此病例及文献复习提出了一种可能的治疗策略。
