Lin Jiun-Nong, Lai Chung-Hsu, Lu Li-Fen, Lin Hsi-Hsun
Department of Critical Care Medicine, Division of Infectious Diseases, and Division of Cardiovascular Surgery, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
South Med J. 2011 May;104(5):360-2. doi: 10.1097/SMJ.0b013e3182142bbd.
Myxoma is the most common primary tumor of the heart. The typical presentations include a triad of embolic phenomena, intracardiac flow obstruction, and constitutional symptoms. We report a case of cardiac myxoma presenting as prolonged fever. Leukocytosis with a left shift, anemia, and elevated C-reactive protein were noted. A large left atrial myxoma was found incidentally by chest computed tomography. The fever subsided after surgical removal of the myxoma. His elevated serum interleukin-4 (IL-4), IL-6, IL-12 p70, interferon-γ, and tumor necrosis factor-α returned to undetectable levels four days after surgery. Cardiac myxomas should be included in the differential diagnosis of prolonged fever, even though no typical symptoms could be found.
黏液瘤是最常见的原发性心脏肿瘤。典型表现包括栓塞现象、心内血流梗阻和全身症状三联征。我们报告一例以长期发热为表现的心脏黏液瘤病例。发现有白细胞增多伴左移、贫血和C反应蛋白升高。胸部计算机断层扫描偶然发现一个巨大的左心房黏液瘤。黏液瘤手术切除后发热消退。术后四天，他升高的血清白细胞介素-4（IL-4）、IL-6、IL-12 p70、干扰素-γ和肿瘤坏死因子-α恢复到检测不到的水平。即使未发现典型症状，心脏黏液瘤也应列入长期发热的鉴别诊断中。
