Chiba Kiyoshi, Abe Hiroyuki, Kitanaka Yosuke, Makuuchi Haruo
Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
Ann Thorac Cardiovasc Surg. 2012;18(4):391-4. doi: 10.5761/atcs.cr.11.01723. Epub 2012 Jan 31.
Atrial myxoma is the most common benign tumor of the heart. Patients who have atrial myxoma usually present with cardiac obstruction, arrhythmia, or peripheral embolization. We encountered an unusual case of acute upper extremity ischemia due to a massive atrial myxoma in a young man. A 38-year-old man was admitted to our hospital with an acute onset of severe, right upper extremity pain and paralysis while working. Neurologic examination yielded normal results, but the patient showed no palpable right radial or ulnar artery. Routine sonographic evaluation revealed acute aortic embolism in his right brachial artery. Because of his young age and otherwise healthy condition, we decided to perform transthoracic echocardiography, which showed a huge left atrial tumor, which we suspected to be myxoma. We then performed urgent concurrent open heart surgery and embolectomy to avoid further embolism. The microscopic findings of the resected tumor and embolism specimens were myxoma. He was discharged without complications.
心房黏液瘤是最常见的心脏良性肿瘤。患有心房黏液瘤的患者通常表现为心脏梗阻、心律失常或外周栓塞。我们遇到了一例不寻常的病例，一名年轻男性因巨大的心房黏液瘤导致急性上肢缺血。一名38岁男性在工作时突然出现严重的右上肢疼痛和麻痹，随后入住我院。神经系统检查结果正常，但患者右侧桡动脉和尺动脉均无法触及。常规超声检查显示其右肱动脉急性主动脉栓塞。鉴于他年轻且身体状况良好，我们决定进行经胸超声心动图检查，结果显示左心房有一个巨大肿瘤，我们怀疑是黏液瘤。然后我们紧急同时进行了心脏直视手术和栓子切除术，以避免进一步栓塞。切除的肿瘤和栓塞标本的显微镜检查结果为黏液瘤。他出院时没有并发症。
