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病例报告:多成分间充质肿瘤导致的右心室流出道梗阻

Case report: Right ventricular outflow tract obstruction caused by multicomponent mesenchymal tumor.

作者信息

Huang Shengyuan, Wang Shiye, Tang Zhixiang, Dai Yinghuan, Song Long

机构信息

Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.

Clinical Nursing Teaching and Research Section, Operation Room, The Second Xiangya Hospital, Central South University, Changsha, China.

出版信息

Front Cardiovasc Med. 2022 Sep 13;9:988271. doi: 10.3389/fcvm.2022.988271. eCollection 2022.

Abstract

Right ventricular outflow tract obstruction (RVOTO) is a cause of hemodynamic instability that can lead to right ventricular dysfunction. Cardiac tumors located in the right ventricle or surrounding structures can cause RVOTO. Herein, we present a rare case of a 21-year-old male with palpitations due to RVOTO caused by a cardiac multicomponent mesenchymal tumor. The tumor was localized in the right ventricular outflow tract, resulting in right side heart enlargement, tricuspid regurgitation, and RVOTO. Hence, tumor resection was performed. The patient was in a stable condition and discharged home on the 6th post-operative day. However, histopathological examination of the tumor specimen suggested a three-component mesenchymal tumor containing mucinous components, formed blood vessels, and fibrous tissue, which is like an atypical capillary hemangioma. After seven years of follow-up, the patient had no right heart enlargement, tricuspid regurgitation, and tumor recurrence. We believe surgical treatment is effective, and this case will provide a reference for clinicians to treat and evaluate the prognosis of similar three-component mesenchymal cardiac tumor cases in the future.

摘要

右心室流出道梗阻(RVOTO)是血流动力学不稳定的一个原因,可导致右心室功能障碍。位于右心室或周围结构的心脏肿瘤可引起RVOTO。在此,我们报告一例罕见病例,一名21岁男性因心脏多成分间叶性肿瘤导致RVOTO而出现心悸。肿瘤位于右心室流出道,导致右侧心脏扩大、三尖瓣反流和RVOTO。因此,进行了肿瘤切除术。患者病情稳定,术后第6天出院。然而,肿瘤标本的组织病理学检查提示为一种包含黏液成分、形成血管的组织和纤维组织的三成分间叶性肿瘤,类似非典型毛细血管瘤。经过七年的随访,患者无右心扩大、三尖瓣反流及肿瘤复发。我们认为手术治疗是有效的,该病例将为临床医生未来治疗和评估类似的三成分间叶性心脏肿瘤病例的预后提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42fa/9513130/8330367835d3/fcvm-09-988271-g0001.jpg

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