File:Neurological manifestation following atrial myxoma (Radiopaedia 35523-37018 Coronal non-contrast 6).png

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Neurological_manifestation_following_atrial_myxoma_(Radiopaedia_35523-37018_Coronal_non-contrast_6).png ‎(586 × 512 pixels, file size: 43 KB, MIME type: image/png)

Summary:

Description
  • Radiopaedia case ID: 35523
  • Image ID: 12052044
  • Image stack position: 6/46
  • Plane projection: Coronal
  • Aux modality: non-contrast
  • Study findings: Evidence of previous right frontoparietal and right occipitoparietal craniotomies and underlying resections Several hemorrhagic lesions are identified: - Left superior parietal lesion measures 12mm x 9mm - Left frontal lesion measures 6mm x 5mm - Left occipital lesion measures 13mm x 12mm. - Right superior parietal lesion measures 6mm x 7mm. These are all at grey-white matter junctions. Other smaller ones may also be present. Mild vasogenic edema surrounds these lesions with mild localized mass effect on the cerebral sulci. Ventricular size is normal. No midline shift. Encephalomalacia in the right frontal and parietal lobes noted. Mastoid air cells and paranasal sinuses are normal. Conclusion: Bilateral hemorrhagic intra-axial lesions since 8/12, in the given clinical context, almost certainly represent new hemorrhagic myxoma metastases.
  • Modality: CT
  • System: Central Nervous System
  • Findings: Multiple discrete intraparenchymal subcortical hemorrhagic foci are demonstrated. Two lesions lie in the right frontal lobe and measure 11x26mm in diameter. An 18mm lesion lies in the right parietal lobe, a 3mm lesion lies in the left occipital lobe, and a tiny focus lies in the left frontal lobe. Assessment of enhancement is difficult given the intrinsic hyperdensity of these lesions, however, there appears to be enhancement of the left frontal lesion and probably the larger of the right frontal lesions. Moderate vasogenic edema surrounds each foci. Findings are highly suspicious for hemorrhagic metastatic disease. In patients of this age, melanoma would represent the most common primary. Hemorrhagic metastases related to atrial myxoma are extremely rare, but have been reported.
Date Published: 12th Apr 2015
Source https://radiopaedia.org/cases/neurological-manifestation-following-atrial-myxoma
Author Rajalakshmi Ramesh
Permission
(Permission-reusing-text)		 http://creativecommons.org/licenses/by-nc-sa/3.0/

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