Multiple Cerebral Aneurysms Caused by Cardiac Myxoma

Sédat, Jacques; Chau, Yves; Dunac, Antoine; Gomez, N.; Suissa, Laurent; Mahagne, Marie Hélène

doi:10.1177/159101990701300209

Cited by 39 publications

(22 citation statements)

References 33 publications

(43 reference statements)

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“… 4 , 5 They are a benign growth originating from multipotential subendocardial mesenchymal cells and are the most common heart tumour, accounting for 50% of all cardiac tumours. 5 , 6 Most cases have been reported in the 40- to 80-year-old age group. There is debate in the literature over whether there is a female predominance.…”

Section: Discussionmentioning

confidence: 99%

“…Atrial myxomas classically manifest with a clinical triad of constitutional symptoms, cardiac dysfunction and embolic phenomena. 5 , 6 Constitutional symptoms are often non-specific and can therefore be misleading. Fever, arthralgia, myalgia, rash and cachexia all occur commonly and can direct clinical suspicion towards infection, systemic inflammatory rheumatologic processes, or disseminated malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…Fever, arthralgia, myalgia, rash and cachexia all occur commonly and can direct clinical suspicion towards infection, systemic inflammatory rheumatologic processes, or disseminated malignancy. 5 , 6 Accompanying laboratory findings can also be non-specific and include leucocytosis, elevated C-reactive protein and erythrocyte sedimentation rate, and/or derangement of liver transaminases (hypothesised to be secondary to cardiohepatic congestion). 5 Cardiac effects are usually due to mechanical obstruction of the chamber or valves but can manifest with arrhythmia, or myocardial dysfunction secondary to direct tumoural infiltration of the myocardium.…”

Section: Discussionmentioning

confidence: 99%

“… 5 Embolic phenomena are systemic or neurologic, and usually precede cardiac failure in the clinical presentation of cardiac myxoma. 4 – 6 A patient presenting with isolated or recurrent embolic events should prompt further assessment with cardiologic examination and non- invasive cardiac imaging to exclude a cardioembolic source.…”

Section: Discussionmentioning

confidence: 99%

“… 5 , 9 Embolisation of tumour particles to the cerebral vessel walls is favoured to be the predominant mechanism for aneurysm formation, with the embolised myxoma cells thought to induce aneurysm formation by penetrating and weakening the vascular walls. 4 – 6 , 9 …”

Section: Discussionmentioning

confidence: 99%

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Heart or head?: A depression mimic delays diagnosis—oncotic cerebral aneurysms caused by atrial myxoma

et al. 2017

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Complications of intracardiac tumours can carry significant morbidity and mortality. This article depicts the case of a female who presented with multiple oncotic intracranial aneurysms secondary to a left atrial myxoma. The clinical manifestations and pathogenesis of cardiac myxoma, as well as the imaging pathway, management and prognosis of myxomatous aneurysms will be discussed. Excision of the cardiac mass is mandatory both for symptomatic improvement and to prevent further embolic complications. Local recurrence and delayed onset cerebral complications do occur, and necessitate ongoing patient follow-up. Our report highlights several important features of the diagnostic and treatment pathway for atrial myxoma—in particular, the potentially non-specific clinical presentation, the pivotal role of cardiac MRI in the multimodality diagnostic imaging work up and the need for multidisciplinary communication to identify the diagnosis and guide appropriate management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Heart or head?: A depression mimic delays diagnosis—oncotic cerebral aneurysms caused by atrial myxoma

et al. 2017

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A 55‐Year‐Old Male Presenting With Altered Mental Status: A Complicated Case of Intracranial Aneurysm

Garg

Khosroshahi

2017

Arthritis Care & Research

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A 55-year-old man was transferred to our hospital for further evaluation of altered mental status and fusiform cerebral aneurysms. History of present illnessA 55-year-old African American male was in good health 5 months prior when he underwent a colonoscopy as part of a routine colon cancer screening. After the procedure, he developed colitis and was treated with antibiotics for 5 days with resolution of his symptoms. One month after this episode he was admitted at an outside hospital for constellation of fever, bilateral ankle swelling, and petechial pruritic rash on his lower extremities. The patient did not experience other symptoms such as weight loss, cough, hemoptysis, painful vision loss, oral ulcers, neurologic deficits, or gastrointestinal bleeding. During this hospitalization, the patient was found to have an elevated creatinine level of 2.65 mg/dl. Additional laboratory values were hemoglobin (9.8 gm/dl), white blood cells (5,000/ll), platelets (200,000/ll), normal liver enzymes, and low albumin (2.8 mg/dl). The serologic studies revealed elevated rheumatoid factor (RF; 114 IU/ml, normal value <20 IU/ml) and low complements C3 (49 mg/dl, normal value 80-252 mg/dl) and C4 (9 mg/dl, normal value 12-17 mg/dl), while other serologic markers, antineutrophil cytoplasmic antibody (ANCA), proteinase 3 (PR3) antibody, myeloperoxidase (MPO) antibody, antinuclear antibody (ANA), and cryoglobulins, were reported to be negative. His urinalysis revealed red blood cell (RBC) casts, dysmorphic RBCs, and 2+ protein. Given his presentation with constitutional symptoms, rash, and elevated creatinine with subnephrotic range proteinuria and casts, he underwent a kidney biopsy, the findings of which revealed "necrotizing glomerulonephritis with crescents, pauci-immune staining pattern with glomerular C3 dense deposit, which could be seen in infectious process-like endocarditis/abscesses." The patient was diagnosed with ANCA-associated vasculitis (AAV) based on a pauciimmune staining pattern and cresentric glomerulonephritis on his kidney biopsy results, and he was started on 60 mg of daily oral prednisone and 100 mg of daily oral cyclophosphamide. The patient continued these doses of prednisone and cyclophosphamide for 3 months without significant improvement in his proteinuria (persistently 2+ on urine dipstick, 1.5 gm on quantification) and creatinine levels (remained elevated in range 1.6-2.2 mg/dl).The patient was admitted again at an outside hospital for evaluation of shortness of breath and chest tightness. He was found to have mild elevation in cardiac enzymes and underwent cardiac catheterization as part of cardiac assessment. Soon after cardiac catheterization, he became delirious and was found to have an intracranial hemorrhage. An angiogram at the outside hospital highlighted an intracranial aneurysm; he was transferred to our hospital for embolization of the aneurysm. Upon arrival, he was intubated for airway protection and underwent repeat angiogram with demonstration of 2 fusiform aneurysms. Medical and famil...

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Etoposide/carboplatin chemotherapy for the treatment of metastatic myxomatous cerebral aneurysms

et al. 2014

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Multiple Cerebral Aneurysms Caused by Cardiac Myxoma

Abstract: A case of multiple cerebral aneurysms caused by left atrial myxoma is reported. We present the details of this case and discuss the hypothetical pathogenesis, radiological aspects and treatment of these neoplastic aneurysms.

Cited by 39 publications

References 33 publications

Heart or head?: A depression mimic delays diagnosis—oncotic cerebral aneurysms caused by atrial myxoma

Heart or head?: A depression mimic delays diagnosis—oncotic cerebral aneurysms caused by atrial myxoma

A 55‐Year‐Old Male Presenting With Altered Mental Status: A Complicated Case of Intracranial Aneurysm

Etoposide/carboplatin chemotherapy for the treatment of metastatic myxomatous cerebral aneurysms

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