Brain metastases in a patient with antecedent of cardiac myxoma: a case report and review of literature

Abstract

Introduction: 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.

Case presentation: 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.

Conclusion: 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.