Chonnam Med J.  2011 Apr;47(1):45-47. 10.4068/cmj.2011.47.1.45.

Cerebellar Embolization in Patients with Heart Murmur

• Lee MG
• Park JC
• Ahn BH
• Jeong MH

• KMID: 2172245
• DOI: http://doi.org/10.4068/cmj.2011.47.1.45

Abstract

A 76-year-old female present to the emergency department with dysarthria, dizziness, dyspnea. The patient had hypertension and atrial fibrillation. Brain MRI revealed right cerebellar infarction. Transthoracic echocardiography showed a large round mass in the left atrium. Transesophageal echocardiography showed large complex echogenic round mass lesion attached on left atrial side of interatrial septum. Coronary angiogram revealed round movable mass lesion in left atrium with feeding arteries originated from right coronary artery. She underwent removal of mass and Maze operation, and pathologic finding was compatible with myxoma.

Keyword

Neoplasms; Heart; Embolization

MeSH Terms

Aged
Arteries
Atrial Fibrillation
Brain
Coronary Vessels
Dizziness
Dysarthria
Dyspnea
Echocardiography
Echocardiography, Transesophageal
Emergencies
Female
Heart
Heart Atria
Heart Murmurs
Humans
Hypertension
Infarction
Myxoma

Figure

• 

  FIG. 1 Axial T1-weighted image showed a high signal intensity lesion (Left) and the T2-weighted image showed a low signal intensity lesion (Right) in the right cerebellum.

• 

  FIG. 2 Transesophageal echocardiography showed a complex, echogenic, round mass lesion in the left atrial side of the interatrial septum.

• 

  FIG. 3 Left and Right: coronary angiogram revealed no significant stenosis but a round mass lesion in the left atrium with feeding arteries originating from the conus branch and the atrioventricular nodal artery of the right coronary artery.

• 

  FIG. 4 Hematoxylin-eosin staining showed an acid mucopoly-saccharide-rich stroma composed of a myxoid matrix and polygonal cells with scant eosinophilic cytoplasm scattered throughout the matrix. Low power field (×40).

• 

  FIG. 5 Follow-up transthoracic echocardiography after surgery showed no remnant mass lesion in the left atrium.

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