Tekin U N, Khan I A, Singh N, Nair V M, Vasavada B C, Sacchi T J
Division of Cardiology, Long Island College Hospital, Brooklyn, NY, USA.
Can J Cardiol. 2000 Mar;16(3):383-5.
Paragangliomas are rare neoplasms of neural crest origin arising in the chromaffin (pheochromocytoma) and chemoreceptor (chemodectoma) tissues. Only a few cases of paragangliomas have been reported in the heart. Most of the cardiac paragangliomas are located in, or adjacent to, the left atrium. The biological activity indicative of catecholamine production has rarely been shown in cardiac paragangliomas. Patients with cardiac paragangliomas may present with hypertension, or with various obstructive or compressive symptoms, depending on the location of the tumour. A left atrial paraganglioma compressing the esophagus causing dysphagia is presented. A 37-year-old female patient underwent work-up for dysphagia to solids. Transesophageal echocardiography showed the presence of a large mass in the dilated left atrium. The tumour was removed completely intact and was a benign noncatecholamine-secreting paraganglioma. The patient's dysphagia was relieved. The clinical perspectives of cardiac paraganglioma and cardiac dysphagia are discussed.
副神经节瘤是起源于神经嵴的罕见肿瘤,发生于嗜铬组织(嗜铬细胞瘤)和化学感受器组织(化学感受器瘤)。心脏副神经节瘤仅有少数病例报道。大多数心脏副神经节瘤位于左心房或其附近。心脏副神经节瘤很少表现出提示儿茶酚胺分泌的生物学活性。心脏副神经节瘤患者可能出现高血压,或根据肿瘤位置出现各种梗阻或压迫症状。本文报道一例压迫食管导致吞咽困难的左心房副神经节瘤。一名37岁女性患者因固体食物吞咽困难接受检查。经食管超声心动图显示扩张的左心房内有一个大肿块。肿瘤完整切除,为良性非儿茶酚胺分泌性副神经节瘤。患者的吞咽困难得到缓解。本文讨论了心脏副神经节瘤和心脏性吞咽困难的临床观点。