Go Seimei, Furukawa Tomokuni, Yamada Kazunori, Takahashi Shinya
Department of Cardiovascular Surgery, Akane-Foundation Tsuchiya General Hospital, Nakashimacho 3-30, Nakaku Hiroshima-city, Hiroshima, Japan.
Department of Cardiovascular Surgery, Hiroshima University, Hiroshima, Japan.
Indian J Thorac Cardiovasc Surg. 2021 Jan;37(1):97-100. doi: 10.1007/s12055-020-01035-7. Epub 2020 Aug 27.
Rapidly growing papillary fibroelastoma complicated by myxoma is extremely rare. An 80-year-old male was transported to our hospital because of cerebral hemorrhage. Echocardiogram revealed a massive pedunculated tumor in the septum of the left atrium. The tumor extended to the mitral valve orifice and posed a risk of strangulation, yet removing it immediately would have required cardiopulmonary bypass with anticoagulant, which would have posed a serious risk of rebleeding. Magnetic resonance imaging showed that the tumor stalk was sufficiently thick for us to perform a standby surgery 1 month after cerebral hemorrhage. Follow-up echocardiogram prior to this surgery revealed a new, high-mobility tumor in the right ventricular septum. We resected these two tumors together. Histopathological examination showed that the tumor of the left atrium was a myxoma and the tumor of the right ventricle was a papillary fibroelastoma. The patient had a good postoperative course and was discharged without complications.
快速生长的乳头状纤维弹性瘤合并黏液瘤极为罕见。一名80岁男性因脑出血被送至我院。超声心动图显示左心房隔有一个巨大的带蒂肿瘤。肿瘤延伸至二尖瓣口，有绞窄风险，但立即切除需要进行心肺旁路并使用抗凝剂，这会带来再次出血的严重风险。磁共振成像显示肿瘤蒂足够粗，我们在脑出血1个月后进行了择期手术。此次手术前的随访超声心动图显示右心室间隔有一个新的、高活动度的肿瘤。我们将这两个肿瘤一并切除。组织病理学检查显示左心房肿瘤为黏液瘤，右心室肿瘤为乳头状纤维弹性瘤。患者术后恢复良好，无并发症出院。
