Wang Anbiao, Zhang Yiwei, Zi Jie, Xu Lei
Department of Cardiac Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 9677 Jingshi Road, Jinan, Shandong 250021, China.
Department of Health and General Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China.
Eur Heart J Case Rep. 2022 Apr 8;6(5):ytac157. doi: 10.1093/ehjcr/ytac157. eCollection 2022 May.
Epicardial mesothelial cysts are cysts that are attached to the epicardium within the pericardial cavity. Reports on epicardial mesothelial cysts are rare, and limited studies have investigated their surgical management. Here, we report the rare case of an epicardial cyst originating from the roof of the left atrium.
A 73-year-old man with dyspnoea on exertion and lower limb oedema was diagnosed with a giant cyst (diameter, 7 cm × 4.5 cm) in the pericardial cavity using computed tomography. Off-pump surgery was performed with successful resection of the cyst with a pedicle connected to the roof of the left atrium. Histological examination confirmed the mesothelial origin of the tumour cells.
Cysts rarely develop within the pericardial cavity, especially an epicardial cyst. The few studies exploring this disease have suggested that patients with this condition may be asymptomatic or have mild breathlessness or cardiac tamponade, which might be occasionally or incidentally diagnosed. Sufficient preoperative evaluation, particularly involving the coronary artery, is essential, and a rational way of surgery should be planned considering all factors.
心外膜间皮囊肿是附着于心包腔内的心外膜的囊肿。关于心外膜间皮囊肿的报道很少，且仅有有限的研究对其手术治疗进行了探讨。在此，我们报告一例罕见的起源于左心房顶部的心外膜囊肿病例。
一名73岁男性，有劳力性呼吸困难和下肢水肿症状，通过计算机断层扫描诊断为心包腔内有一个巨大囊肿（直径7 cm×4.5 cm）。在非体外循环下进行手术，成功切除了与左心房顶部相连的带蒂囊肿。组织学检查证实肿瘤细胞起源于间皮。
囊肿很少在心包腔内形成，尤其是心外膜囊肿。少数关于这种疾病的研究表明，患有这种疾病的患者可能无症状，或有轻度呼吸困难或心脏压塞，可能偶尔或偶然被诊断出来。充分的术前评估，特别是涉及冠状动脉的评估至关重要，应综合考虑所有因素制定合理的手术方案。
