Ahmed Rafsan, Zaidi Seyed, Feinberg Michelle, Graham-Hill Suzette
Internal Medicine, State University of New York (SUNY) Downstate Medical Center, Brooklyn, USA.
Cardiology, State University of New York (SUNY) Downstate Medical Center, Brooklyn, USA.
Cureus. 2022 Mar 16;14(3):e23238. doi: 10.7759/cureus.23238. eCollection 2022 Mar.
Cardiac tumors (CTs) are a rare group of disorders that encompass a broad set of masses. They are subclassified into neoplastic and non-neoplastic lesions. Neoplastic lesions can be further subdivided into either primary cardiac tumors (PCTs) or secondary cardiac tumors (SCTs) which are metastasis to the heart. Cardiac myxomas are the most common pathological type of benign PCT followed by rhabdomyomas, papillary fibroelastomas, fibromas, lipomas, and leiomyomas. Here, we present a case of a patient with left atrial mass in the setting of stage IV prostate cancer. We have used transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) for characterization and differential generation. Our findings are presented in high-quality imaging and video and our top differentials include PCT, thrombi, and metastasis. Although a full diagnostic workup was not completed due to limitations in diagnostic tests available, metastasis to the heart could not be excluded due to the high staging and extensive sclerotic involvement of this malignancy. We emphasized the importance of multimodality imaging, e.g., TTE, TEE, cardiac magnetic resonance (CMR), and cardiac computed tomography (CT) in the workup of incidental cardiac masses and differential refinement.
心脏肿瘤（CTs）是一组罕见的疾病，包括多种类型的肿块。它们可细分为肿瘤性和非肿瘤性病变。肿瘤性病变可进一步分为原发性心脏肿瘤（PCTs）或继发性心脏肿瘤（SCTs），后者是转移至心脏的肿瘤。心脏黏液瘤是最常见的良性PCT病理类型，其次是横纹肌瘤、乳头状纤维弹性瘤、纤维瘤、脂肪瘤和平滑肌瘤。在此，我们报告一例IV期前列腺癌患者出现左心房肿块的病例。我们使用经胸超声心动图（TTE）和经食管超声心动图（TEE）进行特征描述和鉴别诊断。我们的发现以高质量的影像和视频呈现，我们的主要鉴别诊断包括PCT、血栓和转移瘤。尽管由于可用诊断测试的局限性，未完成全面的诊断检查，但鉴于该恶性肿瘤的高分期和广泛的硬化性累及，不能排除心脏转移。我们强调了多模态成像（如TTE、TEE、心脏磁共振成像（CMR）和心脏计算机断层扫描（CT））在偶然发现的心脏肿块检查和鉴别诊断中的重要性。
