Neurological manifestations of atrial myxoma and stereotactic radiosurgery for metastatic aneurysms
Melanie Hau, Tak Lap Poon and Fung Ching Cheung
Atrial myxomas are the most common primary and benign cardiac tumours. They are believed to originate from multipotential mesenchymal cells (1, 2). Cardiac myxomas have been rarely reported to have various neurological manifestations including embolic stroke (3, 4), intracranial aneurysms and cerebral cavernous malformations (CCM) (5, 6).
Due to the rarity of the disease, optimal treatment has yet to be determined. It has been reported that myxomatous aneurysms can remain static over 15 years with observation (7). Surgical methods are limited by invasiveness especially for multiple recurring aneurysms. Chemotherapy alone has had equivocal results (8). Positive results have been reported with whole brain or focal irradiation followed by chemotherapy (9, 10).
We report the first case where stereotactic SRT was used alone to treat metastatic myxomatous aneurysms. SRT offers the advantages of being less invasive than endovascular or open surgery, avoids the systemic effects of chemotherapy, and limits toxicity to surrounding brain parenchyma compared to whole brain irradiation.
Keywords: stereotactic radiosurgery; myxoma; metastatic; intracranial aneurysm