Cardiac myxoma presenting with sensory neuropathy.
A 51-year-old man was admitted for burning dysesthesias over the soles. Neurologic examination showed a pansensory loss over both feet associated with weakness of toes dorsiflexion. Motor conduction study of the sural nerve showed a significant reduction of nerve conduction velocity (21.4 m/s) suggesting a demyelinating neuropathy. In the following days he was referred to the cardiologist because of the sudden onset of a rapid atrial tachycardia, which was terminated by adenosine. Echocardiography showed a left atrial mass arising from the atrial septum consistent with the diagnosis of cardiac myxoma. The patient underwent cardiac surgery to remove the tumor, which was confirmed a myxoma by pathology. In the days following cardiac mass removal, neurological symptoms progressively disappeared in the absence of anti-inflammatory and steroid therapy and control motor conduction study showed complete normalization of nerve conduction velocity (54.5 m/s). Peripheral demyelinating neuropathy represented the first clinical presentation of cardiac myxoma in our patient and should be included among the possible paraneoplastic manifestations of this cardiac tumor.
Santangeli
Pasquale
P
Pieroni
Maurizio
M
Marzo
Francesca
F
Frontera
Antonio
A
Vitulano
Nicola
N
Luciani
Nicola
N
Bellocci
Fulvio
F
Crea
Filippo
F
D003711:Demyelinating Diseases / Q000209:etiology* / Q000503:physiopathology; D006338:Heart Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D010257:Paraneoplastic Syndromes / Q000150:complications*; D010523:Peripheral Nervous System Diseases / Q000209:etiology* / Q000503:physiopathology; D011984:Sensory Receptor Cells / Q000502:physiology; D014463:Ultrasonography