Transient Ischemic Attack as a Debut of Pterygomaxillary Myxoma: A Case Report

<b>Introduction:</b> Myxomas, typically found in cardiac and soft tissues, rarely occur in the head and neck region. In the nasal cavity or paranasal sinuses, their presentation is exceptional. Cardiovascular events are rarely associated with skull base tumors.<b>Case report:</b> We present a case of a 58-year-old Caucasian male patient who clinically debuted with a 5-minute episode of dysarthria and dysphasia secondary to a left middle cerebral artery-dependent transient ischemic attack (TIA). Radiological studies revealed a left pterygomaxillary lesion measuring 3 x 3 x 4 cm, with sphenoidal extension, intimately contacting and eroding the left paraclival carotid artery. Surgical removal of the lesion was successful, and the patient recovered without further cerebrovascular issues. The lesion was identified as a myxoma through histopathological analysis.<b>Conclusions:</b> This case is uncommon in several aspects. Myxomas, typically found in the maxillary sinus, are rare in other locations within the skull. Skull base tumors causing neurological symptoms due to compression or contact with blood vessels are also unusual. In the literature, similar cases involving skull base tumors leading to ischemic events are scarce. Few cases have been documented, including benign tumors affecting blood flow and leading to symptoms like TIAs or strokes. In summary, the case illustrates a unique instance of a myxoma affecting the skull base, leading to neurological issues, emphasizing the importance of considering rare tumor presentations in diagnosing unusual neurological symptoms.