Cerebral infarction due to cardiac myxoma developed with the loss of consciousness immediately after defecation—a case report—

Ikeda, Toshimasa; Masahiro, Oomura; Sato, Chikako; Anan, Chise; Yamada, Kentaro; Kamimoto, Kaoru

doi:10.5692/clinicalneurol.cn-000856

Cited by 6 publications

(6 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With regard to recanalization therapy for the acute cerebral artery occlusion induced by tumor embolism, Ikeda et al 4 reported the effectiveness of intravenous rt-PA therapy for the thrombus component of the cardiac myxoma embolism; however, it was less effective for the tumor component. In this case, rt-PA was not administered considering a risk of hemorrhagic complications.…”

Section: Discussionmentioning

confidence: 99%

Cerebral tumor embolism from thyroid cancer treated by mechanical thrombectomy: illustrative case

Fujiwara

Hayashi

Shibata

et al. 2023

Journal of Neurosurgery: Case Lessons

View full text Add to dashboard Cite

BACKGROUND Development in mechanical thrombectomy is progressing dramatically. Tumor embolism has been rarely reported on the basis of pathological study of the retrieved thrombus. Herein, the authors report a case of cerebral tumor embolism from advanced thyroid cancer, which was successfully treated with mechanical thrombectomy. OBSERVATIONS A 57-year-old man was diagnosed with thyroid cancer with multiple lung metastases and chemotherapy was planned. He experienced left hemiparesis and was bought to the emergency section of the authors’ hospital. Magnetic resonance angiography revealed right internal carotid artery occlusion and endovascular treatment was performed. Using a combination of aspiration catheter and stent retriever, white jelly-like embolus was retrieved. The pathological study demonstrated thyroid cancer embolism. Pulmonary vein invasion following lung metastasis of thyroid cancer was most presumably the cause of the tumor embolism. LESSONS Lung metastasis invading the pulmonary vein may be a cause of tumor embolism. Mechanical thrombectomy using a combination of stent retriever and aspiration catheter is effective in removing the tumor embolus and the pathological examination of the embolus is essential.

show abstract

Section: Discussionmentioning

confidence: 99%

Cerebral tumor embolism from thyroid cancer treated by mechanical thrombectomy: illustrative case

Fujiwara

Hayashi

Shibata

et al. 2023

Journal of Neurosurgery: Case Lessons

View full text Add to dashboard Cite

show abstract

“…1) The thrombus retrieved from our patient pathologically consisted of 70% thrombotic components and 30% tumor components. Ikeda et al 15) treated patients with cerebral embolism due to myxoma of the heart by IV rt-PA therapy, and reported that the effectiveness of IV rt-PA was limited against emboli with a high tumor component percentage. IV rt-PA therapy was contraindicated in our patient because of hemoptysis, but considering the high percentage of ICA: internal carotid artery; MCA: middle cerebral artery; PcomA: posterior communicating artery; BA: basilar artery; IV rt-PA: intravenous rt-PA; MT: mechanical thrombectomy; SR: stent-retriever; ADAPT: a direct aspiration first pass technique; CT: combined technique; NR: not reported fibrillation, but eventually diagnosed as tumor embolism based on pathological findings.…”

Section: Discussionmentioning

confidence: 99%

Mechanical Thrombectomy for Acute Middle Cerebral Artery Occlusion Caused by Tumor Embolism: A Case Report

Moriyama

Sugiura

Hayashi

et al. 2021

JNET

View full text Add to dashboard Cite

We report a case of acute middle cerebral artery (MCA) occlusion caused by tumor embolism. Case Presentation: A 64-year-old man with lung cancer presented with sudden onset left-sided hemiparesis and sensory disturbance. Diffusion-weighted imaging (DWI) revealed hyper-intense foci in the right MCA territory and magnetic resonance angiography (MRA) demonstrated right MCA M2 segment occlusion. Mechanical thrombectomy (MT) was performed with Thrombolysis in Cerebral Infarction 2B recanalization. On histopathology, thrombus composed of fibrin and squamous cell carcinoma was observed. We diagnosed him with tumor embolism from lung cancer that invaded the pulmonary vein and the left atrium. Conclusion: Tumor cells may be confirmed by pathological examination regardless of the morphology of the embolus. Pathological examination of the cerebral embolus is useful for the accurate diagnosis of ischemic stroke subtypes.

show abstract

“…The histopathological study of the cardiac mass confirms the diagnosis of AM. The surgical treatment consists of the total resection of the intra-atrial mass which should be prompt enough and complete to avoid embolism and other cardiac complications [4][5][6]. When an AM is diagnosed with any imaging methodology it usually implies immediate consequent surgical excision to prevent embolic events.…”

Section: Discussionmentioning

confidence: 99%

“…Atrial myxomas tend to differ in shape, size, and texture, and originate from the vicinity of the fossa ovalis in the inter-atrial septum in 75% of cases like in the patient that we are presenting here. The clinical and differential diagnosis of AM is based on imaging methodology like echocardiography, cardiac computerized tomography or cardiac magnetic resonance imaging [5][6][7][8]. These imaging techniques provide detailed information about de structure of the tumor mass, its mobility, size, and myocardial invasion.…”

Section: Discussionmentioning

confidence: 99%

Refractory Heart Failure despite Optimized Medical Treatment Which Subsides only after Surgical Resection of a Large Left Atrial Myxoma

2017

JCCR

View full text Add to dashboard Cite

Submit Manuscript | http://medcraveonline.com depends on the size, mobility and location of the AM. It can be asymptomatic, although the typical symptoms involve systemic embolism, heart failure, or non-specific symptoms. Systemic embolism occurs in 25% to 50% of left AM and about half of them travel to the central nervous system [2,3]. The clinical diagnosis of AM is based on imaging methodology like echocardiography, cardiac computerized tomography or cardiac magnetic resonance imaging. These imaging techniques provide detailed information about de structure of the tumor mass, its mobility, size, and myocardial invasion. The histopathological study of the cardiac mass confirms the diagnosis of AM [4]. In order to avoid embolism and other cardiac and systemic complications total surgical resection of the intra-atrial myxoma should be done as soon as possible. Therefore, we are presenting this relatively uncommon disease of a left atrial myxoma developing refractory heart failure which subsides only after surgical resection of this intra-atrial mass. Case ReportA 59-year-old woman with diabetes mellitus presented with complaints of progressive dyspnea, orthopnoea, inferior limbs oedema that began about 6 months earlier with milder symptoms. She denied previous consultation and treatment. At the time of hospitalization, she was in New York Heart Association (NYHA) functional class IV in sinus rhythm; her blood pressure was 140/90 mmHg. She had mild bilateral basal lung congestion and ascites, mild hepatomegaly and inferior limbs oedema was present. The first heart sound was increased. A soft middiastolic mitral murmur was present, as well as, a grade III/VI pan-systolic mitral murmur heard best at the apex and radiated to the axilla. The conventional electrocardiogram showed sinus rhythm. Transthoracic color-flow Doppler echocardiography revealed a hyper-echogenic large left intra-atrial mass (49 x 44 mm) suggesting an atrial myxoma which was attached to the inter-atrial septum (Figure 1). She also had moderate mitral regurgitation due to valve coaptation failure, mild to moderate left atrial dilatation (48 mm), and moderate pulmonary hypertension with a peak systolic pulmonary artery pressure of 47 mmHg. Mitral valve diastolic velocity was increased to 2.3 m/s with a mean pressure gradient of 10 mmHg. The LV ejection fraction was 69%. Blood tests were within normal limits. The carotid Doppler ultrasound, as well as, the coronary angiogram revealed arteries within normal limits. Despite optimized medical treatment installed for the signs and symptoms of her heart failure there was no improvement in her clinical condition.After obtaining informed consent, the patient underwent successful surgical resection of the intra-atrial mass which consisted of a soft white and yellowish friable myxomatous mass that measured about 5 x 5.5 approximately (Figure 2) which was confirmed to be an atrial myxoma with histological studies AbstractA 59-year-old woman with diabetes mellitus who presented with complaints of progressive...

show abstract

Cerebral infarction due to cardiac myxoma developed with the loss of consciousness immediately after defecation—a case report—

Cited by 6 publications

References 17 publications

Cerebral tumor embolism from thyroid cancer treated by mechanical thrombectomy: illustrative case

Cerebral tumor embolism from thyroid cancer treated by mechanical thrombectomy: illustrative case

Mechanical Thrombectomy for Acute Middle Cerebral Artery Occlusion Caused by Tumor Embolism: A Case Report

Refractory Heart Failure despite Optimized Medical Treatment Which Subsides only after Surgical Resection of a Large Left Atrial Myxoma

Contact Info

Product

Resources

About