Shuo Zhang1,2, Qian Zhang1,2, Hai Yu3, Longqi Liu4, Rujing Sun5, Xiaowen Song1,2, Xianzeng Tong6, Yueshan Piao7, Xin Chen1,2, Jun Wu1,2, Yong Cao1,2, Shuo Wang1,2, Jizong Zhao8,9. 1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China. 2. China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China. 3. Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. 4. Departments of Neurosurgery, Jishuitan Hospital, Peking University, Beijing, People's Republic of China. 5. Department of Neuroimaging, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China. 6. Departments of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. 7. Departments of Pathology, Xuanwu Hospital, Capital Medical University, Beijing, China. 8. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China. zhaojz205@163.com. 9. China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China. zhaojz205@163.com.
Abstract
PURPOSE: Myxoma-related intracranial diseases were rarely documented in history. The main purpose of our study is to provide a more comprehensive and detailed understanding of the pathogenesis, imaging features, surgical procedures and pathology of such patients through long-term follow-up. METHODS: From March 2012 to July 2018, baseline information that included neuroimaging and neuropathology data from 12 cardiac myxoma patients with neurological symptoms were retrospectively analysed, and the treatment options were discussed. Nine patients underwent long-term postoperative follow-up. RESULTS: Twelve cardiac myxoma patients with neurological symptoms were identified, and among them, 10 patients were postoperative patients who had undergone excision of cardiac myxoma, 5 patients had received craniotomy, and the others had received conservative treatment. Positive neuroimaging findings were found in all patients, including cerebral infarction (12/12, 100%), multiple intracranial aneurysms (8/12, 67%), and extravascular metastasis (6/12, 50%). After a long-term average follow-up of 27 months, an increased number of metastatic lesions or an enlargement of the intracranial aneurysms was found in 4 patients. CONCLUSIONS: Neuroimaging findings of myxoma-related intracranial lesions were diversed and usually presented as multiple cerebral infarction, aneurysm formation, focal intracranial haemorrhage and space-occupying lesions. Progress is over a long period of time after primary tumour resection. It is necessary for patients to be regularly examined within 2 years after cardiac myxoma resection using MRI+CTA/MRA/DSA in order to be ruled out. Stable and effective chemotherapy drugs are urgently needed.
PURPOSE:Myxoma-related intracranial diseases were rarely documented in history. The main purpose of our study is to provide a more comprehensive and detailed understanding of the pathogenesis, imaging features, surgical procedures and pathology of such patients through long-term follow-up. METHODS: From March 2012 to July 2018, baseline information that included neuroimaging and neuropathology data from 12 cardiac myxomapatients with neurological symptoms were retrospectively analysed, and the treatment options were discussed. Nine patients underwent long-term postoperative follow-up. RESULTS: Twelve cardiac myxomapatients with neurological symptoms were identified, and among them, 10 patients were postoperative patients who had undergone excision of cardiac myxoma, 5 patients had received craniotomy, and the others had received conservative treatment. Positive neuroimaging findings were found in all patients, including cerebral infarction (12/12, 100%), multiple intracranial aneurysms (8/12, 67%), and extravascular metastasis (6/12, 50%). After a long-term average follow-up of 27 months, an increased number of metastatic lesions or an enlargement of the intracranial aneurysms was found in 4 patients. CONCLUSIONS: Neuroimaging findings of myxoma-related intracranial lesions were diversed and usually presented as multiple cerebral infarction, aneurysm formation, focal intracranial haemorrhage and space-occupying lesions. Progress is over a long period of time after primary tumour resection. It is necessary for patients to be regularly examined within 2 years after cardiac myxoma resection using MRI+CTA/MRA/DSA in order to be ruled out. Stable and effective chemotherapy drugs are urgently needed.
Authors: Christian D Nagy; Michael Levy; Thomas J Mulhearn; Maryam Shapland; Henry Sun; David D Yuh; Dickson Cheung; Nisha Chandra-Strobos Journal: J Stroke Cerebrovasc Dis Date: 2009 Sep-Oct Impact factor: 2.136