Yamaguchi Masaomi, Yagi Kentaro, Ikeya Eriko, Fujimura Takabumi, Taguchi Junichi, Shibuya Makoto, Inamura Shunichi, Kanabuchi Kazuo
Department of Cardiovascular Surgery, Tokai University School of Medicine, Bohseidai, Isehara-shi, Kanagawa 259-1193, Japan.
Tokai J Exp Clin Med. 2006 Jul 20;31(2):56-9.
The case was a Japanese man of 62 years old. A bulbar mass attached to mitral valve anterior leaflet was discovered in an echocardiography within detailed examination of ischemic heart disease accidentally. We diagnosed him as ischemic heart disease and doubt of heart tumor. We thought about the danger of future embolism, surgical treatment was decided. We dissected the tumor together with one chorda tendineae of mitral valve, and a performed aorta - coronary bypass surgery. We diagnosed the tumor as papillary fibroelastoma by pathological diagnosis. Papillary fibroelastoma is extremely rare with 7-9% of benign tumor of heart primary. Most of the papillary fibroelastoma is incidentally discovered by echocardiography or autopsy. Or it is discovered for systemic embolism. The tumor is benign, but there is a problem to cause embolism. Therefore, when we discovered papillary fibroelastoma, surgical resection of the tumor is the first-line therapy. A problem on surgical therapy is the range of resection area. Papillary fibroelastoma is benign tumor, but the pathological characteristic is still unidentified. Further epidemiological and pathological studies are necessary to determine the extent of surgical excision in associated with characteristics of papillary fibroelastoma.
该病例为一名62岁的日本男性。在对缺血性心脏病进行详细检查的超声心动图检查中,意外发现一个附着于二尖瓣前叶的延髓肿块。我们诊断他患有缺血性心脏病并怀疑有心脏肿瘤。考虑到未来栓塞的风险,决定进行手术治疗。我们将肿瘤连同二尖瓣的一根腱索一起切除,并进行了主动脉-冠状动脉搭桥手术。通过病理诊断,我们将该肿瘤诊断为乳头状纤维弹性瘤。乳头状纤维弹性瘤极为罕见,占原发性心脏良性肿瘤的7-9%。大多数乳头状纤维弹性瘤是通过超声心动图或尸检偶然发现的。或者是因系统性栓塞而被发现。该肿瘤是良性的,但存在导致栓塞的问题。因此,当我们发现乳头状纤维弹性瘤时,手术切除肿瘤是一线治疗方法。手术治疗的一个问题是切除区域的范围。乳头状纤维弹性瘤是良性肿瘤,但其病理特征仍未明确。需要进一步的流行病学和病理学研究来确定与乳头状纤维弹性瘤特征相关的手术切除范围。