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Peer-reviewedCC BY-NC-ND 4.0International Journal of Surgery Case Reports

Coexisting left atrial myxoma-like mass and pulmonary vein metastatic component of adrenocortical carcinoma presenting with cardioembolic stroke: a case report

  • Fulya Topuz1
  • Derih Ay2
  • Haluk Mevre Özgöz1
  • Cemalettin Yılmaz3
  • Enes Arslan3
  • Ezgi Işıl Turhan4
4 affiliations
  1. 1Department of Cardiovascular Surgery, Yalova Training and Research Hospital, Yalova, Türkiye
  2. 2Department of Cardiovascular Surgery, Bursa City Hospital, Bursa, Türkiye
  3. 3Department of Cardiology, Yalova Training and Research Hospital, Yalova, Türkiye
  4. 4Department of Pathology, Bursa City Hospital, Bursa, Türkiye
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Abstract

Background:: Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with a strong tendency for early metastatic dissemination. Cardiac metastases are exceptionally uncommon and usually occur through tumor extension via the inferior vena cava into the right atrium, rather than as isolated left-sided involvement. Intracardiac metastases may mimic primary cardiac tumors such as atrial myxomas, creating diagnostic challenges and increasing the risk of systemic embolization.

Case presentation:: A patient with a history of ACC presented with transient neurological deficits consistent with cardioembolic stroke. Brain magnetic resonance imaging demonstrated multiple acute embolic infarcts. Transthoracic and transesophageal echocardiography revealed two distinct left atrial masses, one attached to the interatrial septum and another highly mobile lesion extending toward the left superior pulmonary vein.

Management and outcome:: Urgent surgical intervention was performed due to the high embolic risk. Both lesions were completely excised, and histopathological examination confirmed metastatic ACC.

Conclusion:: Cardiac metastases should be considered in patients with ACC who present with embolic events and left atrial masses.

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Cite

BibTeXRIS
BibTeX
@article{topuz2026coexisting,
  title = {{Coexisting left atrial myxoma-like mass and pulmonary vein metastatic component of adrenocortical carcinoma presenting with cardioembolic stroke: a case report}},
  author = {Fulya Topuz and Derih Ay and Haluk Mevre Özgöz and Cemalettin Yılmaz and Enes Arslan and Ezgi Işıl Turhan},
  journal = {International Journal of Surgery Case Reports},
  year = {2026},
  month = oct,
  doi = {10.1097/rc9.0000000000001140},
  url = {https://doi.org/10.1097/rc9.0000000000001140},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Coexisting left atrial myxoma-like mass and pulmonary vein metastatic component of adrenocortical carcinoma presenting with cardioembolic stroke: a case report
AU  - Fulya Topuz
AU  - Derih Ay
AU  - Haluk Mevre Özgöz
AU  - Cemalettin Yılmaz
AU  - Enes Arslan
AU  - Ezgi Işıl Turhan
PY  - 2026
DA  - 2026/10/09
JO  - International Journal of Surgery Case Reports
DO  - 10.1097/rc9.0000000000001140
UR  - https://doi.org/10.1097/rc9.0000000000001140
AB  - Background:: Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with a strong tendency for early metastatic dissemination. Cardiac metastases are exceptionally uncommon and usually occur through tumor extension via the inferior vena cava into the right atrium, rather than as isolated left-sided involvement. Intracardiac metastases may mimic primary cardiac tumors such as atrial myxomas, creating diagnostic challenges and increasing the risk of systemic embolization.  Case presentation:: A patient with a history of ACC presented with transient neurological deficits consistent with cardioembolic stroke. Brain magnetic resonance imaging demonstrated multiple acute embolic infarcts. Transthoracic and transesophageal echocardiography revealed two distinct left atrial masses, one attached to the interatrial septum and another highly mobile lesion extending toward the left superior pulmonary vein.  Management and outcome:: Urgent surgical intervention was performed due to the high embolic risk. Both lesions were completely excised, and histopathological examination confirmed metastatic ACC.  Conclusion:: Cardiac metastases should be considered in patients with ACC who present with embolic events and left atrial masses.
SN  - 2210-2612
ER  -