ISSN (Online): 2789 - 2832 / ISSN (Print): 2789 - 2824Equipa Multidisciplinar de Profissionais de Saúde, Docentes e Investigadores Nacionais

Multiple cerebral aneurysms originating from previously resected cardiacmyxoma

Adilson José Manuel de Oliveira  1,2 Gustavo Correa Lordelo 1 , Saul Almeida da Silva 1, 3 , José Guilherme 3 Pereira Caldas , Rhuann Pontes dos Santos Silva 4 , Eberval Gadelha Figueredo 1

ABSTRACT

Primary cardiac tumors are very rare, accounting for 0,001 – 0,03% in autopsy series, cardiac myxoma (CM) account forapproximately 50% of them. Association between CM and cerebral aneurysm is well documented in this condition but theoccurrence of cerebral aneurysm after resection of CM is very rare, with only 40 reports in medical literature. We presenta case of a 45 years old female patient with multiple cerebral aneurysms 2 years after a successful resection of cardiacmyxoma, submitted to radiosurgery for 2 bigger aneurysms with good results. This report ads to literature new clinicalfindingsand a hypothesis of radiosurgery as an effective option of treatment for cerebral aneurysms with origin in CM. Keywords:Cardiac Myxoma; Cerebral aneurysm; Radiosurgery; Neurosurgery. Keywords : Cardiac Myxoma; Cerebral aneurism; Radiosurgery; Neurosurgery

INTRODUCTION Cardiac tumors are rare lesions generally secondary lesions in continuity 1 or metastatics 2 .Primary cardiactumors are very rare, accounting for 0,001 – 0,03% in autopsy series 3 , cardiac myxoma (CM) account forapproximately 50% of them4. The World Health Organization (WHO) defines CM as a neoplasm composed bystellate to plump, cytologically bland, mesenchymal cells set in a myxoid stroma 5 .Neurological complications may be the result of thrombus formation, such as intracranial aneurysms, infarcts,hemorrhages, brain metastases and cerebral vascular disorders can be associated with CM. Association betweenCM and cerebral aneurysm is well documented on this condition 6 but delayed cerebral aneurysm formation afterresection of CM is very rare, due only 40 reports in medical literature being the first description in 1894 byMarchand 7 . Anyway, there are no prospective studies or cases with enough follow up to define the natural history,pathogenesis and earlier treatment remains unexplained.We present a case of a 45 years old female patient with multiple cerebral aneurysms 2 years after a successfulresection of cardiac myxoma, submitted to radiosurgery for 2 bigger aneurysms with good results.

CASE REPORT A 45 years old woman with 2 months of history of progressive dyspnea, initially for moderate efforts and attime of admission at hospital was for small efforts as daily routine activities. The medical history reveals childhoodpoliomyelitis with flaccid right upper limb monoplegia, no other relevant information.The cardiac examination reveals a grade III apical murmur with no other relevant findings, neurological examination

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1- Vascular Neurosurgery, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, SP – Brazil.Orcid: 0000-0001-6104-569X 2- Neurosurgery Service, Clínica Girassol, Luanda, Angola 3- Endovascular Group, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, SP – Brazil 4- Catholic University of Pernambuco, Recife, PE - Brazil

 - Autor correspondente. Email: adilsonvalmont@gmail.com DOI: https://doi.org/10.54283/RACSaude.v2n2.2021.p10-13 Recebido : 03 de Maio de 2021 / Aceite : 06 de Junho de 2021 / Publicado : 30 de Junho de 2021

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