Freixa Marta, Simões André Ferreira, Rodrigues Joana Barbosa, Úria Sara, da Silva Glória Nunes
Internal Medicine Service, Hospital Pulido Valente, Lisbon, Portugal.
Intensive Care Unit, Hospital de Vila Franca de Xira, Vila Franca de Xira, Portugal.
Oxf Med Case Reports. 2019 May 31;2019(5):omz029. doi: 10.1093/omcr/omz029. eCollection 2019 May.
Occam's razor, the principle that a single explanation is the most likely in medicine, assumes that when a patient has multiple symptoms the clinician seeks a single diagnosis rather than diagnosing multiple and different ones. However, as proposed by Hickam's dictum, sometimes rare different diseases occurred in only one patient. We present a patient with a simultaneous diagnosis of two rare tumours, a cardiac hemangioma (primary cardiac tumour, often misdiagnosed as myxoma) and an appendiceal mucocele (a lesion of the appendix that can be neoplastic or not). A 71-year-old male presented with anorexia, asthenia, fever and weight loss for about one month. During the etiological investigation, a cardiac mass and an appendiceal lesion were detected and both lesions required surgical intervention. Cardiac and abdominal surgeries were uneventful and full recovery was achieved. The histological examination showed a cardiac hemangioma and a neoplastic appendiceal mucocele.
奥卡姆剃刀原理，即在医学中单一解释最有可能的原则，假定当患者有多种症状时，临床医生寻求单一诊断而非诊断多种不同疾病。然而，正如希卡姆格言所提出的，有时罕见的不同疾病会出现在同一患者身上。我们报告一例同时诊断出两种罕见肿瘤的患者，一个心脏血管瘤（原发性心脏肿瘤，常被误诊为黏液瘤）和一个阑尾黏液囊肿（阑尾的一种病变，可能是肿瘤性的也可能不是）。一名71岁男性出现厌食、乏力、发热和体重减轻约1个月。在病因调查期间，检测到一个心脏肿物和一个阑尾病变，两个病变均需手术干预。心脏和腹部手术均顺利，患者完全康复。组织学检查显示为心脏血管瘤和肿瘤性阑尾黏液囊肿。
