Myxoma in the carotid artery. Myxomatous occlusion of internal carotid artery.

Abstract

We describe a patient with an unusual cause of internal carotid artery occlusion resulting in a stroke. A 41-year-old woman presented with a typical acute right middle cerebral artery territory infarct. Her hematological and cardiological status was assessed, including all extracranial vessels. Carotid angiography and a biopsy were performed of the occluded right internal carotid artery and demonstrated a myxoma. Cardiac investigations to determine the source of the myxoma, including transthoracic and transesophageal echocardiograms, CT and yo-yo CT scans, and MRI of the heart, were normal. No residual tumor or potential source of the tumor was found. The cause of stroke was a myxomatous occlusion of the right internal carotid artery. An entire cardiac tumor may have embolized with no detectable residual tumor in the heart; alternatively, a myxoma may have originated as a primary tumor in the carotid artery. To our knowledge, no primary myxoma has been reported to have originated in a blood vessel.