Meng XH, Xie LS, Xie XP, Liu YC, Huang CP, Wang LJ, Zhang GH, Xu D, Cai XC, Fang X. Cardiac myxoma shedding leads to lower extremity arterial embolism: A case report. World J Clin Cases 2022; 10(29): 10606-10613 [PMID: 36312464 DOI: 10.12998/wjcc.v10.i29.10606]
Corresponding Author of This Article
Xin Fang, MAMS, Chief Physician, Department of Vascular Surgery, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China. fangxin19800324@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xiao-Hu Meng, Xu-Pin Xie, Yong-Chang Liu, Lin-Jun Wang, Dong Xu, Xin Fang, Department of Vascular Surgery, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Le-Si Xie, Department of Pathology, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Chang-Pin Huang, Guo-Hui Zhang, Xu-Chao Cai, Department of General Surgery, Hangzhou Geriatrics Hospital, Hangzhou 310006, Zhejiang Province, China
Author contributions: Meng XH contributed to the study conception and writing; Meng XH and Fang X contributed to the data collection and investigation; Meng XH and Xie LS contributed to the analysis; all authors contributed to the critical review and revision, final approval of the article and accountability for all aspects of the work.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report. A copy of the written consent is available for review from the Editor-in-Chief of this journal.
Conflict-of-interest statement: All authors have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin Fang, MAMS, Chief Physician, Department of Vascular Surgery, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China. fangxin19800324@163.com
Received: April 13, 2022 Peer-review started: April 13, 2022 First decision: June 27, 2022 Revised: July 7, 2022 Accepted: September 7, 2022 Article in press: September 7, 2022 Published online: October 16, 2022
Abstract
BACKGROUND
Left cardiac myxoma (CM) is the most common benign tumor of primary cardiac tumors, but because of its special position caused by pathological physiology change, caused by the complications of the heavier, the surface is often accompanied by blood clots, once fall out, it causes peripheral vascular embolization, such as acute lower limb artery embolization, harmfulness is large, high morbidity, and easy to occur repeatedly.
CASE SUMMARY
A 67-year-old male patient suddenly appeared numbness and weakness of the left lower limb and could not walk without obvious incentive. The patient was finally diagnosed as left CM complicated with acute lower limb arterial embolism after completing cardiac ultrasound, computer tomography angiography, and histopathological analysis, such as hematoxylin-eosin stain staining, immunohistochemistry and special staining including alcian blue staining and periodic acid schiff staining. Arterial thrombosis was removed successfully by femoral artery thrombectomy, postoperative numbness and weakness of the patient's left lower limb disappeared, skin temperature became warm, and dorsal foot artery pulsation was accessible. The patient was readmitted to the hospital 8 mo after discharge for left atrial mass resection, and was diagnosed as CM by postoperative histopathological examination.
CONCLUSION
Although CM is rare, it may be considered as the source of embolism in patients with acute limb ischemia. Repeated loss of thrombus on the tumor and its surface may lead to repeated embolism of peripheral vessels. Cardiac ultrasound is helpful for early diagnosis. Here, we use this case report to highlight left CM as an important cause of acute limb ischemia and to report our experience in the diagnosis and treatment of lower limb arterial embolism caused by CM detachment.
Core Tip: Cardiac myxoma (CM), although rare, is a unique cause of acute arterial embolism, we report a rare case of this type and provide insights into the diagnosis and treatment of acute lower extremity arterial embolism caused by shedding of left CM. We hope that by improving the recognition of the disease, we can reduce intervention time and thus avoid delays in diagnosis and treatment.
