Xia Min, Wang Yi, An Xuefeng, Huang Yufeng, Wei Ke, Zhou Jia, Li Kun, Yao Guojie, Huang He
Department of Neurosurgery, Central Theater Command General Hospital of the People's Liberation Army, Wuhan, China.
Department of Anesthesiology, Central Theater Command General Hospital of the People's Liberation Army, Wuhan, China.
J Int Med Res. 2025 Apr;53(4):3000605251333690. doi: 10.1177/03000605251333690. Epub 2025 Apr 25.
Atrial myxoma is the most common primary benign tumor of the heart, with over 75% occurring in the left atrium. The migration of myxoma cells can lead to rare neurological complications such as intracranial aneurysms, embolic strokes, and arteriovenous malformations. The most common neurological manifestations in such patients include seizures, nonspecific headaches, and cerebrovascular events. Herein, we present a rare case of a middle-aged man in his early 50s with metastatic myxomatous multiple fusiform aneurysms, who initially presented with the clinical manifestation of intracerebral hemorrhage. The patient underwent atrial myxoma resection, whereas the intracranial multiple fusiform aneurysms were managed conservatively. Four years later, digital subtraction angiography revealed progressive enlargement of the aneurysm in the A3 segment of the left anterior cerebral artery. We present the pathological report of the atrial myxoma and imaging findings showing the changes in the aneurysms, along with a review and summary of the relevant literature. This report offers new insights into treatment options for cases of atrial myxoma complicated with intracranial multiple aneurysms. This is the first reported case of a male patient in China presenting with intracerebral hemorrhage as the initial manifestation of atrial myxoma combined with multiple fusiform aneurysms.
心房黏液瘤是最常见的原发性心脏良性肿瘤,超过75%发生于左心房。黏液瘤细胞的迁移可导致罕见的神经系统并发症,如颅内动脉瘤、栓塞性中风和动静脉畸形。此类患者最常见的神经学表现包括癫痫发作、非特异性头痛和脑血管事件。在此,我们报告一例罕见病例,一名50岁出头的中年男性患有转移性黏液瘤性多发梭形动脉瘤,最初表现为脑出血的临床表现。患者接受了心房黏液瘤切除术,而颅内多发梭形动脉瘤则采取保守治疗。四年后,数字减影血管造影显示左大脑前动脉A3段的动脉瘤逐渐增大。我们展示了心房黏液瘤的病理报告和显示动脉瘤变化的影像学结果,并对相关文献进行了回顾和总结。本报告为心房黏液瘤合并颅内多发动脉瘤病例的治疗选择提供了新的见解。这是中国首例以脑出血为心房黏液瘤合并多发梭形动脉瘤初始表现的男性患者报告。