Rao Venugopal R, Jagannath Kolwalkar, Sunil Putane K, Madhusudana Narayan
Department of Cardiothoracic and Vascular Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.
Interact Cardiovasc Thorac Surg. 2012 Aug;15(2):290-1. doi: 10.1093/icvts/ivs129. Epub 2012 Apr 25.
Cardiac tuberculosis is rare and usually involves the pericardium. Myocardial tuberculoma is a very rare occurrence and only a few cases have been reported. We describe a rare case of cardiac tuberculoma involving the whole of the lateral right atrial wall, extending from the superior vena cava/right atrial junction up to a tricuspid valve. The initial diagnosis of right atrial myxoma was made based on the echocardiography report and surgical excision was planned. Intraoperatively, the excision of the mass was deferred due to the extensive nature of the disease and a high suspicion of malignancy. Cardiac tuberculoma was confirmed by histopathological examination. The patient made a remarkable recovery with the complete disappearance of the mass after anti-tuberculous treatment, as viewed by a postoperative echocardiography during the follow-up.
心脏结核较为罕见,通常累及心包。心肌结核瘤极为罕见,仅有少数病例报道。我们描述了一例罕见的心脏结核瘤病例,该结核瘤累及整个右心房外侧壁,从上腔静脉/右心房交界处延伸至三尖瓣。根据超声心动图报告初步诊断为右心房黏液瘤,并计划进行手术切除。术中,由于病情广泛且高度怀疑为恶性肿瘤,肿物切除被推迟。组织病理学检查确诊为心脏结核瘤。随访期间术后超声心动图显示,抗结核治疗后肿物完全消失,患者恢复良好。