Multiple cerebral and coronary aneurysms in a patient with left atrial myxoma
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Multiple cerebral and coronary aneurysms in a patient with left atrial myxoma Hyungjin Kim • Eun-Ah Park • Whal Lee Jin Wook Chung • Jae Hyung Park
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Received: 11 September 2012 / Accepted: 10 October 2012 / Published online: 25 October 2012 Ó Springer Science+Business Media Dordrecht 2012
Abstract Cardiac myxomas accompanied by multiple embolic complications in cerebral and visceral arteries have been well documented in scientific literature. However, cerebral artery aneurysms have rarely been reported as a possible embolic complication of myxomas. This study describes a patient who had multiple episodes of cerebral infarctions and was found to have left atrial myxoma with old renal infarction as well as cerebral and coronary artery aneurysms. This is the first case report of coronary artery aneurysms associated with cardiac myxoma. Keywords Coronary aneurysm Cerebral aneurysm Myxoma Emboli Cardiac magnetic resonance imaging
intracardiac obstruction and constitutional symptoms such as fever, weight loss and anemia [2]. Cardiac myxoma can be treated with surgical resection, although recurrent cases have been reported [3]. Interestingly, myxomarelated aneurysms, which are most commonly located in the middle cerebral artery, have been found to occur before and after the surgical resection of myxomas [1]. To the best of our knowledge, there have been no published cases of myxoma-related coronary artery aneurysms to date. This study reports a novel case of cardiac myxoma with multiple cerebral and coronary aneurysms and analyzes the findings by using cardiac cine magnetic resonance imaging (MRI).
Case report Introduction Cardiac myxoma is a tumor that is thought to originate from multipotential mesenchymal cells and is most often located in the left atrium [1]. This benign tumor can result in repeated events of cerebral and peripheral embolism,
Electronic supplementary material The online version of this article (doi:10.1007/s10554-012-0140-3) contains supplementary material, which is available to authorized users. H. Kim E.-A. Park (&) W. Lee J. W. Chung J. H. Park Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 110-744 Seoul, Korea e-mail: [email protected] E.-A. Park W. Lee J. H. Park SNU-Duke Cardiovascular MR Research Center, Seoul National University, Seoul, Korea
A 58-year-old woman visited a local hospital for the evaluation of right flank pain which had persisted for several days. Her medical history revealed that she had suffered from three separate episodes of stroke with rightsided hemiplegia and dysarthria, 20 years prior to this admission. Transthoracic echocardiography demonstrated a left atrial mass and she was transferred to our hospital. On cardiac cine MRI, a highly mobile elongated mass attached to the left atrial septum was noted (Fig. 1a–d and online resource 1, 2). The T1-weighted image showed homogeneous enhancement of the mass after gadolinium administration, which was highly suggestive of cardiac myxoma (Fig. 1e, f). Abdominal co
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