Recurrent Embolic Stroke Associated with Long-Latency Relapsing Cardiac Myxoma

Cardiac myxoma is the most common benign cardiac tumor. Although it has a very low reported incidence of 0.5-1 per 1,000,000 person-years, it is a potentially devastating cause of cardioembolic stroke. About 12% of cardiac myxoma cases are associated with neurologic disorders, most commonly ischemic stroke. 1 Surgical resection is the treatment of choice, and the recurrence rate was reportedly less than 1% per year, predominantly within 4 years. 2 Transthoracic echocardiographic screening is currently recommended in postoperative settings, but there is little evidence over appropriate duration or periods of follow-up strategies. Here we report a patient who presented with recurrent cardiac myxoma revealed by an embolic stroke event that occurred 12 years after complete resection, which had gone undetected during 9 years of routine echocardiographic follow-ups.