Acute Lower Limb Ischemia Revealing Myxoma of the Left Atrium: A Case Report and Review of the Literature

The observation of a 52-year-old hypertensive patient is reported. This is a patient undergoing treatment admitted to the emergency department for severe acute ischemia of the left lower limb with coldness of the entire leg, cyanosis and sensory-motor paralysis. An angioscanner exam was carried out to objective a total thrombosis of the left primary iliac artery without revision. The patient was admitted to the operating room, having had an embolectomy by a left Scarpa approach, gelatinous thrombus was recovered from the iliac and fibrino-cruoric thrombus from the superficial and deep femoral artery, due to the severe ischemia it was considered to perform discharge fasciotomies to avoid the risk of postoperative re-vascularization syndrome. In view of the yellowish and gelatinous nature of the thrombus, histological examination was performed confirming the presence of myxoid cells. The patient had very good functional progress having recovered the motor skills of the toes, and at day 5, he had his myxoma surgically removed. The postoperative follow-up was without any particularity, a regular scanner exam was recommended in order to detect any possible tumor recurrence. Observations reported in the literature have described cases of aortic thrombosis with bilateral ischemia and their evolution was marked by death due to re-vascularization syndrome This observation is reported in order to remind surgeons of the embolic nature of atrial myxoma due to its friability and to encourage them to analyze the nature of the thrombus for early diagnosis and timely management.