Delayed intracranial aneurysm of left atrial myxoma--a case report

Although embolism is known as a common complication in the early growing stage of atrial myxoma, development of further neurologic disorders after the removal of tumor is rarely encountered. Arterial aneurysm formation and metastatic tumor growth represent the two disorders that had been reported in the literature. Based on the pathogenesis of hematogeneous disseminating, atrial myxoma may lodge its fragment or its adherent thrombus on intracranial vessels to produce cerebral infarct. Besides, several reports have indicated that myxoma emboli in the cerebral vessels may invade the vessel wall to produce delayed disorders. Embolization from atrial myxoma is now recognized as a potentially treatable cause of cerebral infarct. However, the long-term course following resection of the tumor remain complicated, partly due to these inconsistent delayed complications, or the therapeutic dilemma. We report a case with delayed intracranial aneurysm formation and reviewed the literature. A 67-year old woman with a past history of left cerebral infarction was transferred to our hospital for further evaluation of her gross hematuria. Infarction of the left kidney was then demonstrated by angiography. A left atrial myxoma was found in a echocardiographic screen, and the patient received a successful resection of the myxoma subsequently. Unfortunately, three episodes of stroke developed in a half year after the operation of the cardiac myxoma.(ABSTRACT TRUNCATED AT 250 WORDS)