Multiple deep white matter lesions mimic multiple sclerosis as an unusual complication of left atrial myxoma

Abstract

We report the case of a patient who developed right hemiparesis with an acute onset 2 weeks before being transferred to our hospital. The brain MRI revealed multiple lesions in deep white matter; some were ovoid and perpendicular to the lateral ventricle, typical of cerebral demyelinating disease such as multiple sclerosis. The patient reported no history of hypertension, diabetes, dyslipidemia or other conventional vascular risk factors. The initial diagnosis was clinically isolated syndrome. However, low fever and petechiae in the extremities developed during hospitalization, which reminded us of cardioembolism. Echocardiography finally revealed a left atrial myxoma. The patient’s symptom alleviated after resection of the tumor.