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二尖瓣黏液瘤的临床病理谱

Clinicopathological Spectrum of Mitral Valve Myxoma.

作者信息

Aguilar Cristian, Espinoza Daniel, Segura Pedro, Donet Jean A

机构信息

Laboratory of Pathology, Instituto Nacional Cardiovascular, Lima, Peru.

Department of Cardiology, Instituto Nacional Cardiovascular, Lima, Peru.

出版信息

J Heart Valve Dis. 2017 Nov;26(6):693-699.

Abstract

Cardiac myxomas are the most common primary tumors of the heart. Although these tumors have been reported in all cardiac chambers, myxomas arising from heart valves are extremely rare. Here, the details are described of a patient with mitral valve myxoma, and a review is provided of 99 cases reported in the literature. Mitral valve myxomas most often occur in middle-aged patients, with a slight female predominance. Most of the tumors arise in an isolated fashion on the atrial side of the anterior mitral valve leaflet. Embolic events were the most frequent manifestation, followed by obstructive symptoms. Unlike atrial wall myxomas, these tumors have a lower incidence of constitutional manifestations. Tumor resection with valve preservation is the usual method of surgical treatment in isolated tumors, while most patients with multiple valve myxomas underwent valve replacement. Mitral valve myxomas should be considered in the differential diagnosis of mitral valve tumors, with an awareness of a relatively high risk of embolic events. This location should not raise suspicion for a heritable myxoma syndrome. Prompt surgical resection is warranted to reduce complications.

摘要

心脏黏液瘤是最常见的原发性心脏肿瘤。尽管这些肿瘤在所有心腔中均有报道,但起源于心脏瓣膜的黏液瘤极为罕见。本文详细描述了一例二尖瓣黏液瘤患者,并对文献报道的99例病例进行了综述。二尖瓣黏液瘤最常发生于中年患者,女性略占优势。大多数肿瘤孤立地发生于二尖瓣前叶心房侧。栓塞事件是最常见的表现,其次是梗阻症状。与心房壁黏液瘤不同,这些肿瘤全身表现的发生率较低。对于孤立性肿瘤,通常的手术治疗方法是保留瓣膜进行肿瘤切除,而大多数多瓣膜黏液瘤患者则接受瓣膜置换。在二尖瓣肿瘤的鉴别诊断中应考虑二尖瓣黏液瘤,同时要意识到栓塞事件的风险相对较高。这个部位不应引起对遗传性黏液瘤综合征的怀疑。应及时进行手术切除以减少并发症。

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