Multiple Cerebral Aneurysms and Brain Metastasis from Primary Cardiac Myxosarcoma: A Case Report and Literature Review

Primary neoplasms of the heart are rare. Malignant cardiac myxoma, or so-called myxosarcoma, accounts for about 6% of primary malignant cardiac tumors. Cerebral metastasisof malignant cardiac myxoma is extremely rare; only three cases have been reported and twoof them included an autopsy study. The case described herein is the first reported brainmetastasis combined with multiple cerebral aneurysms originating from primary cardiacmyxosarcoma. The true incidence of cerebral myxomatous aneurysm is unknown and thepathogenesis of myxomatous aneurysm formation has not been fully defined. The currenthypothesis favors that tumor materials from cardiac myxomas embolize into the vasa vasorum of the peripheral arteries and subsequently prolifere in the vessel wall. This then leadsto a weakening of subintimal tissue, such as the internal elastic lamina, with subsequentaneurysm formation. The prognosis of cardiac myxosarcoma is very poor. Although malignancies most likely develop from the mesenchymal cells, they are difficult to treat with anymodality (operation, chemotherapy, radiotherapy or transplantation) because these tumorshave usually undergone extensive spread by the time the diagnosis is made.