Atrial myxoma with metastasis misdiagnosed as Takayasu arteritis.
The objective of the study is to report a case of atrial myxoma with bloodstream metastasis misdiagnosed to be Takayasu arteritis. A 23-year-old woman manifested with fever, repetitive vasocerebral events and extremities ischemic signs (claudication, difference of BP in arms and absence of pulse) for 5 years. Imaging studies revealed multiple cerebral infarction, bilateral iliac artery stenosis and as thrombosis formation. Takayasu arteritis was diagnosed according to American College of Rheumatology criteria. Glucosteroids and immunosuppressants were given; however, symptoms were not relieved even after treatment. Echocardiography suggested a mass in left atrium, which was surgically removed and pathologically confirmed to be atrial myxoma. Clinical symptoms completely relieved after operation. In conclusion, atrial myxoma with bloodstream metastasis sometimes presented with similar clinical symptoms of Takayasu arteritis and may lead to misdiagnosis of these two diseases. Usually, accepted diagnosis criteria are not enough in distinguishing these diseases. Echocardiography should be considered in these patients.
Tan
Chun-Yu
CY
Division of Rheumatology and Immunology, Department of Medicine, West China Hospital of Sichuan University, 37# Guoxue Road, Wuhou District, 610041, Chengdu, China.
Qin
Wei
W
Lin
Hui
H
Wang
Zhong-Ming
ZM
Xie
Qi-Bing
QB
Liu
Yi
Y
D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology; D006338:Heart Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D009232:Myxoma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D009362:Neoplasm Metastasis / Q000175:diagnosis* / Q000473:pathology; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D013625:Takayasu Arteritis / Q000175:diagnosis*; D014463:Ultrasonography; D055815:Young Adult
ANZ J Surg. 2005 Mar;75(3):110-7
15777385
Chest. 2003 Dec;124(6):2408
14665536
Arthritis Rheum. 1995 Aug;38(8):1161-8
7639815
Curr Opin Rheumatol. 2005 Jan;17(1):16-24
15604900
N Engl J Med. 1995 Dec 14;333(24):1610-7
7477198
Medicine (Baltimore). 2001 May;80(3):159-72
11388092
Am J Cardiol. 1999 Jun 1;83(11):1579-82, A8
10363879
Nat Genet. 2000 Sep;26(1):89-92
10973256
Lancet. 2000 Sep 16;356(9234):1023-5
11041416
J Clin Neuroophthalmol. 1992 Sep;12(3):207-9
1401169