Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara, Turkey.
Cardiovasc Pathol. 2012 Mar-Apr;21(2):e15-8. doi: 10.1016/j.carpath.2011.01.006. Epub 2011 Mar 11.
Myxomas are the most common type of primary cardiac tumors and are usually localized in the atrium. The clinical features of the disease depend on the size, location, mobility, and fragility of the mass. In our case report, we present a 38-year-old female patient admitted to our hospital with typical exertional angina and dyspnea. Diagnosis of giant cystic/hemorrhagic atrial myxoma was established after imaging modalities including echocardiography, angiography, and radiology and the pathological evaluation of the mass. On the coronary angiography, a significant feeding artery of the tumor originating from the right coronary artery and the cystic/hemorrhagic appearance all raised the suspicion for the presence of other cardiac masses. However, the pathological evaluation of the mass was reported as consistent with myxoma, with many prominent cystic and hemorrhagic fields and no evidence of malignancy. Since large intratumoral hemorrhagic fields and the presence of a significant feeding artery secondary to tumor neovascularization were observed, we hypothesized that the remarkable amount of blood flow from the coronary artery to the giant myxoma may result in a kind of coronary steal phenomenon and typical anginal symptoms of the patient.
黏液瘤是最常见的原发性心脏肿瘤，通常位于心房。该疾病的临床特征取决于肿块的大小、位置、活动度和易碎性。在我们的病例报告中，我们介绍了一位 38 岁的女性患者，因典型的劳力性心绞痛和呼吸困难而入院。在包括超声心动图、血管造影和影像学以及对肿块的病理评估等多种影像学手段检查后，诊断为巨大囊性/出血性心房黏液瘤。在冠状动脉造影中，肿瘤来源于右冠状动脉的一个显著供血动脉以及囊性/出血性外观均提示可能存在其他心脏肿块。然而，对肿块的病理评估报告为黏液瘤，有许多明显的囊性和出血性区域，没有恶性肿瘤的证据。由于观察到肿瘤内大量出血区域和由于肿瘤新生血管形成而存在的显著供血动脉，我们假设来自冠状动脉的大量血流进入巨大黏液瘤可能导致一种冠状动脉窃血现象和患者典型的心绞痛症状。
