Achuthanandan Supraja, Harris Chad L, Farooqui Arafat A, Hollander Gerald
Internal Medicine, Maimonides Medical Center, Brooklyn, USA.
Cardiology, Maimonides Medical Center, Brooklyn, USA.
Cureus. 2022 Jun 16;14(6):e26014. doi: 10.7759/cureus.26014. eCollection 2022 Jun.
Cardiac tumors are an uncommon phenomenon. Although they can be cardiac in origin, most represent a distant neoplastic growth metastasizing to the heart. Cardiac tumors can be benign or malignant. They may be symptomatic or, more commonly, found incidentally. Clinical presentation is typically related to that of dispersed neoplasm. We report a case of a 36-year-old young man with an unusually large and smooth-surfaced right ventricular mass. The patient presented to the emergency department with exertional dyspnea for two weeks. Past medical history was significant for deep venous thrombosis with non-adherence to anti-coagulation. Computerized tomographic (CT) angiography showed bilateral pulmonary emboli and a hypodense opacity in the right ventricle. A transthoracic echocardiogram showed a right ventricular non-mobile mass. The patient underwent surgical removal of the mass, which pathology demonstrated to be a thrombus. Cardiac masses can be difficult to differentiate based on imaging alone. Physicians should maintain a high index of suspicion for intracardiac thrombi as early identification and prompt treatment are imperative in improving patient outcomes.
心脏肿瘤是一种罕见的现象。尽管它们可能起源于心脏,但大多数是远处肿瘤生长转移至心脏。心脏肿瘤可以是良性的或恶性的。它们可能有症状,或者更常见的是偶然发现。临床表现通常与转移性肿瘤相关。我们报告一例36岁青年男性,其右心室有一个异常大且表面光滑的肿块。该患者因劳力性呼吸困难两周就诊于急诊科。既往病史有深静脉血栓形成且未坚持抗凝治疗。计算机断层扫描(CT)血管造影显示双侧肺栓塞以及右心室内一个低密度影。经胸超声心动图显示右心室有一个不活动的肿块。患者接受了肿块切除术,病理结果显示为血栓。仅基于影像学很难区分心脏肿块。医生应高度怀疑心内血栓,因为早期识别和及时治疗对于改善患者预后至关重要。