左房黏液瘤致脑梗死及脑转移1例并文献复习

doi:10.6040/j.issn.1671-7554.0.2022.0402

摘要/Abstract

摘要： 目的对1例左房黏液瘤致脑梗死及脑转移患者的临床表现、影像学特征、治疗方法进行分析,以提高临床医生对该疾病的诊疗能力。方法回顾1例诊断为左房黏液瘤脑转移患者的临床资料并进行分析,结合相关文献对该疾病进行总结。结果患者为69岁、男性,入院前6个月因急性脑梗死检查发现左心房占位,术后病理显示左房黏液瘤;入院前3个月检查发现颅内多发占位;入院完善相关检查,行手术治疗,术后病理显示:心房黏液瘤转移。结论心房黏液瘤可引起多发急性脑梗死及脑转移,对于多发急性脑梗死患者有必要进行心脏超声检查,脑转移通常在诊断为心脏黏液瘤的同时或几个月后发现,因此,心房黏液瘤患者需要长期随访。

关键词: 心房黏液瘤, 急性脑梗死, 脑转移

Abstract: Objective To investigate the clinical manifestations, imaging features and treatment methods of a patient with cerebral infarction and brain metastasis caused by left atrial myxoma. Methods The clinical data of the patient were retrospectively analyzed, and relevant literature was reviewed. Results The patient was a 69-year-old male. Six months before admission, due to acute cerebral infarction, he underwent relevant examinations and left atrial lesion was detected; postoperative pathology after surgery showed left atrial myxoma. Three months before admission, multiple intracranial space-occupying lesions were detected. After admission, relevant examinations were conducted and surgery was performed. Postoperative pathology showed metastasis of atrial myxoma. Conclusion Atrial myxoma can cause multiple acute cerebral infarction and brain metastasis. Cardiac ultrasound is necessary for patients with multiple acute cerebral infarction. Brain metastasis is usually found at the same time or a few months after the diagnosis of cardiac myxoma. Therefore, long-term follow-up is necessary for patients with atrial myxoma.

Key words: Atrial myxoma, Acute cerebral infarction, Brain metastasis

中图分类号:

R651.1

刘芷瑞,郭文强,黄德章,王志刚. 左房黏液瘤致脑梗死及脑转移1例并文献复习[J]. 山东大学学报 (医学版), 2022, 60(10): 82-86.

LIU Zhirui, GUO Wenqiang, HUANG Dezhang, WANG Zhigang. Cerebral infarction and brain metastasis caused by left atrial myxoma: a case report and literature review[J]. Journal of Shandong University (Health Sciences), 2022, 60(10): 82-86.

参考文献

[1] Rose D, Papa A, Tomao S, et al. Cerebral metastases in patients with left atrial Myxoma[J]. J Card Surg, 2016, 31(5): 289-293.
[2] Badrisyah I, Saiful R, Rahmat H, et al. Brain metastasis of atrial Myxoma: case report[J]. Med J Malaysia, 2012, 67(6): 613-615.
[3] Lee SJ, Kim JH, Na CY, et al. Eleven years experience with Korean cardiac myxoma patients: focus on embolic complications[J]. Cerebrovascular Dis(Basel, Switzerland), 2012, 33(5): 471-479.
[4] Jawaid A, Naqvi SY, Wiener R. Atrial myxoma presenting as acute ischaemic stroke and chronic right lower leg claudication[J]. BMJ Case Rep, 2018, 11(1). e227427. doi: 10.1136/bcr-2018-227427.
[5] Radoi MP, Stefanescu F, Arsene D. Brain metastases and multiple cerebral aneurysms from cardiac myxoma: Case report and review of the literature[J]. Br J Neurosurg, 2012, 26(6): 893-895.
[6] Kierdaszuk B, Gogol P, Kolasa A, et al. Multiple metastatic intracranial lesions associated with left atrial myxoma[J]. Pol J Radiol, 2014, 79: 262-267. doi: 10.12659/PJR.890332.
[7] 周明阳,杨秀滨,华琨,等.国内单中心1106例心脏黏液瘤的临床分析及手术治疗[J/OL].中国胸心血管外科临床杂志,2021,5:1-5[2022-09-15]. http://kns.cnki.net/kcms/detail/51.1492.R.20210511.1018.004.html.
[8] 李志刚, 徐志云, 邹良建, 等. 心脏黏液瘤新的分型探讨——附复发性心脏粘液瘤二例报告及国内文献复习[J]. 中国胸心血管外科临床杂志, 2010, 17(1): 13-17. LI Zhigang, XU Zhiyun, ZOU Jianliang, et al. Discussion of Clinical Classification of Cardiac Myxoma-With Report of Recurrent Cases and Review of Domestic Literature[J]. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2010, 17(1): 13-17.
[9] Ekinci EI, Donnan GA. Neurological manifestations of cardiac myxoma: a review of the literature and report of cases[J]. Intern Med J, 2004, 34(5): 243-249.
[10] Wen XY, Chen YM, Yu LL, et al. Neurological manifestations of atrial myxoma: a retrospective analysis[J]. Oncol Lett, 2018, 16(4): 4635-4639.
[11] Rose D, Papa A, Tomao S, et al. Cerebral Metastases in Patients with Left Atrial Myxoma[J]. J Card Surg, 2016, 31(5): 289-293.
[12] 张强, 胥宝泉, 范祥云, 等. 心房黏液瘤脑转移一例并文献复习[J]. 中华神经外科杂志, 2011, 27(2): 193-194.
[13] Inayat F, Hussain A, Riaz I, et al. Atrial myxoma presenting as abdominal pain: an unusual association[J]. BMJ Case Rep, 2019, 12(2). e228447. doi: 10.1136/bcr-2018-228447.
[14] Radoi MP, Stefanescu F, Arsene D. Brain metastases and multiple cerebral aneurysms from cardiac myxoma: case report and review of the literature[J]. Br J Neurosurg, 2012, 26(6): 893-895.
[15] Asranna AP, Kesav P, Nagesh C, et al. Cerebral aneurysms and metastases occurring as a delayed complication of resected atrial Myxoma: Imaging findings including high resolution Vessel Wall MRI[J]. Neuroradiology, 2017, 59(5): 427-429.
[16] Mo R, Mi L, Zhou Q, et al. Outcomes of surgical treatment in 115 patients with primary cardiac tumours: a 15-year experience at a single institution[J]. J Thorac Dis, 2017, 9(9): 2935-2941.
[17] Bernet F, Stulz PM, Carrel TP. Long-term remission after resection, chemotherapy, and irradiation of a metastatic myxoma[J]. Ann Thorac Surg, 1998, 66(5): 1791-1792.
[18] Reynen K. Cardiac myxomas[J]. N Engl J Med, 1995, 333(24): 1610-1617.
[19] Jr D, Frist WH, Stinson EB, et al. Primary cardiac neoplasms. Early and late results of surgical treatment in 42 patients[J]. J Thorac Cardiovasc Surg, 1987, 93(4): 502-511.
[20] Gerbode F, Kerth WJ, Hill JD, et al. Surgical management of tumors of the heart[J]. Surgery, 1967, 61(1): 94-101.
[21] Blondeau P. Primary cardiac tumors-French studies of 533 cases[J]. Thorac Cardiovasc Surg, 1990, 38(Suppl 2): 192-195.
[22] Hanson EC, Gill CC, Razavi M, et al. The surgical treatment of atrial myxomas[J]. Clinical experience and late results in 33 patients[J]. J Thorac Cardiovasc Surg,1985, 89(2): 298-303.
[23] Kumar A, Deopujari CE, Karmarkar VS. A rare diagnosis of multiple hemorrhagic metastases in brain[J]. J Postgrad Med, 2011, 57(3): 214-217.
[24] Al-Said Y, Al-Rached H, Baeesa S, et al. Emergency excision of cardiac myxoma and endovascular coiling of intracranial aneurysm after cerebral infarction[J]. Case Rep Neurol Med, 2013, 2013: 839270. doi: 10.1155/2013/839270.
[25] Ezerioha N, Feng W. Intracardiac Myxoma, Cerebral Aneurysms and Elevated Interleukin-6[J]. Case Rep Neurol, 2015, 7(2): 152-155.
[26] Jain S, Maleszewski JJ, Stephenson CR, et al. Current diagnosis and management of cardiac myxomas[J]. Expert Rev Cardiovasc Ther, 2015, 13(4): 369-375.

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