Left atrial myxoma metastasizing to the brain: a case report and review of literature.

Radiation oncology journal Pub Date : 2024-12-01 Epub Date: 2024-12-20 DOI:10.3857/roj.2024.00395
Anna Basu, Natalie Grindrod, A Rashid Dar, Andrew Leung, Matt Cecchini, Michael Lock
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Abstract

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.

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左心房黏液瘤转移至脑:1例报告及文献复习。
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。大约75%的黏液瘤发生在左心房,增加了系统性血栓栓塞事件的风险。虽然心房黏液瘤通常是良性的,但很少转移到大脑,据报道少于60例。我们报告一位56岁的女性,她有左心房黏液瘤病史,在心脏手术三个月后出现头痛、右臂无力和视力模糊。影像学显示多发脑出血性病变,行全脑放射治疗(20 Gy/5分数)。四年后,患者病情稳定,无新病变,功能完全恢复。目前,对于心脏黏液瘤转移没有标准的治疗方法。本病例强调放射治疗在治疗左心房黏液瘤脑转移中的潜在作用,并根据本病例和文献综述提出一种可能的治疗策略。
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