Delayed multiple hemorrhagic brain metastases from atrial myxoma: a case report and literature review.
Hemorrhagic brain metastases from atrial myxoma appeared 5 months after cardiac resection.
Delayed multiple hemorrhagic brain metastases from atrial myxoma: a case report and literature review.
Brain metastases from atrial myxoma are rare central nervous system manifestations and may mimic hemorrhagic malignant metastases or vascular lesions.
We retrospectively reviewed the clinical course, multimodal neuroimaging, surgical findings, histopathology, immunohistochemistry, vascular imaging, and follow-up of a woman in her early 70s.
The patient presented with recurrent dizziness, gait instability, right-sided weakness, and incomplete homonymous hemianopia.
Preoperative CTA showed no suspicious intracranial aneurysm.
Histology showed spindle/stellate cells in abundant myxoid stroma, and immunohistochemistry was positive for calretinin and CD31 but negative for GFAP and desmin, supporting brain metastases from atrial myxoma.
At 6-month follow-up, MRI showed no local recurrence and repeat CTA showed no suspicious aneurysm.
Delayed hemorrhagic brain metastases from atrial myxoma should be considered when patients with a history of cardiac myxoma develop new neurological symptoms and multiple hemorrhagic enhancing brain lesions.
Diagnosis requires integration of clinical history, neuroimaging, vascular imaging, radiology-pathology correlation, and immunohistochemistry.
Treatment and surveillance should be individualized because embolic stroke, myxomatous aneurysms, and parenchymal metastases may coexist and recurrence can occur after long latency.