Division of Cardiothoracic Surgery, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, USA.
New Brunswick Cardiology Group, 75 Veronica Avenue, Suite 101, Somerset, NJ, USA.
J Cardiothorac Surg. 2021 May 20;16(1):136. doi: 10.1186/s13019-021-01514-x.
Cardiac fibromas are rare benign cardiac neoplasms, most frequently occurring in the pediatric population; with very rare cases identified in adults. The tumors are comprised of spindled cells with myofibroblastic ultrastructural features embedded in generally collagenous and elastic stroma. The tumors are intramural in the ventricles, most commonly the left ventricle. Clinical symptoms vary by location and size of tumor and some are asymptomatic. Surgical resection is curative, but rare cases require cardiac transplantation.
We report an asymptomatic, large, right ventricular fibroma in a 64-year-old woman. The patient underwent open incisional tumor biopsy via lower hemi-sternotomy, followed by complete tumor resection via full sternotomy a week later after confirming the tumor is benign. The tumor was resected using cardiopulmonary bypass, and the defect of right ventricular free wall was repaired using a prosthetic double-patch technique. The postoperative course was uneventful. The patient was discharged to home on day 4 post-complete tumor resection.
This report expands the existing literature for better comprehension and detection of cardiac fibroma patients and also highlights the various imaging modalities, surgical management, and histological analysis.
心脏纤维瘤是一种罕见的良性心脏肿瘤，多发生于儿童；但也有非常罕见的成人病例报告。肿瘤由梭形细胞组成，具有成纤维细胞的超微结构特征，嵌入通常为胶原和弹性的基质中。肿瘤位于心室壁内，最常见于左心室。临床症状因肿瘤的位置和大小而异，有些患者无症状。手术切除是治愈性的，但少数情况下需要进行心脏移植。
我们报告了一例 64 岁女性无症状、巨大的右心室纤维瘤。患者经下半身胸骨切开术行开放性切口肿瘤活检，一周后，在确认肿瘤为良性后，通过完全胸骨切开术行完整肿瘤切除术。肿瘤切除采用体外循环，使用人工双补片技术修复右心室游离壁的缺损。术后过程顺利。患者在完全切除肿瘤后第 4 天出院回家。
本报告扩展了现有的文献，以更好地理解和检测心脏纤维瘤患者，并强调了各种影像学、手术管理和组织学分析。
