Echocardiography and Vascular Ultrasound Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Heart Surg Forum. 2020 Mar 24;23(2):E165-E169. doi: 10.1532/hsf.2947.
Coronary artery aneurysms are not uncommon vascular anomalies, but giant coronary artery aneurysms mimicking cardiac tumors are extremely rare and easily misdiagnosed as tumors. The management and prognosis are not well defined.
We describe a case of a 50-year-old woman, who had a transthoracic echocardiogram that suggested a cardiac tumor in the right ventricle adjacent to the tricuspid valve and without ventricular wall akinesia. Her medical history was unremarkable, and she had no obvious symptoms. A transesophageal echocardiogram and computed tomography angiogram examination suggested the tumor-like structure was a giant coronary aneurysm, originating from the distal portion of right coronary artery. The patient underwent surgical intervention and recovered uneventfully. Histopathology of the excised aneurysm showed fibrous tissue hyperplasia with collagenization and calcification in the wall of the artery.
Giant coronary artery aneurysms resembling heart tumors are extremely rare. Differentiating them from cardiac tumors can sometimes be difficult. This rare case emphasizes the importance of combining multiple imaging methods, which helps make accurate diagnosis. For treatment, surgical intervention may be the appropriate therapeutic strategy for the rare lesion.
冠状动脉瘤并不少见，但类似于心脏肿瘤的巨大冠状动脉瘤极为罕见，容易误诊为肿瘤。其处理和预后尚无明确定论。
我们描述了一位 50 岁女性患者，经胸超声心动图检查提示右心室紧邻三尖瓣处有一心脏肿瘤，且室壁运动正常。患者既往史无特殊，无明显症状。经食管超声心动图和计算机断层血管造影检查提示该肿瘤样结构为起源于右冠状动脉远端的巨大冠状动脉瘤。患者接受了手术干预，恢复顺利。切除动脉瘤的组织病理学显示动脉壁内纤维组织增生，伴有胶原化和钙化。
类似于心脏肿瘤的巨大冠状动脉瘤极为罕见。有时，区分它们与心脏肿瘤可能具有一定难度。本例罕见病例强调了结合多种影像学方法的重要性，有助于做出准确诊断。对于治疗，手术干预可能是这种罕见病变的合适治疗策略。
