Rao Jin, Yang Qian, Yin Liang, Yu Yue, Xi Wang, Xu Jibin, Zhang Yufeng, Wang Zhinong
Department of Cardiothoracic Surgery, Changzheng Hospital, Naval Medical University, Shanghai, China.
Front Surg. 2023 Feb 27;10:1140016. doi: 10.3389/fsurg.2023.1140016. eCollection 2023.
Myxoma constitutes the main subtype of all benign cardiac tumors, tending to be more common in women and occurring mostly in the left and right atria. Its classic clinical presentations are intracardiac obstruction, embolization, and systemic or constitutional symptoms, such as fever, in decreasing order. Several imaging techniques such as echocardiography, computed tomography, and angiocardiography contribute to the diagnosis of myxoma, ruling out significant coronary diseases, and assessment of myocardial invasion and tumor involvement of adjacent structures. Surgical resection is the only effective therapeutic option for patients with cardiac myxoma. Here, we report a unique case of a middle-aged man who presented with a giant myxoma and a 3-day history of chest tightness and shortness of breath after physical activity. Subsequently, transthoracic echocardiography revealed a mass of solid echodensity located within the right ventricle, complicated by abnormal hemodynamics. A cardiac computed tomographic angiography showed a large homogeneous density filling defect consuming most parts of the right ventricle and protruding from beat to beat. A surgical resection and histological study later successfully confirmed the diagnosis, and the patient's postoperative recovery course was found to be uneventful.
黏液瘤是所有心脏良性肿瘤的主要亚型，在女性中更为常见，主要发生于左、右心房。其典型临床表现依次为心脏内梗阻、栓塞以及全身或全身症状，如发热。超声心动图、计算机断层扫描和心血管造影等多种成像技术有助于黏液瘤的诊断，排除严重冠状动脉疾病，并评估心肌浸润及肿瘤对相邻结构的累及情况。手术切除是心脏黏液瘤患者唯一有效的治疗选择。在此，我们报告一例独特病例，一名中年男性，患有巨大黏液瘤，并有体力活动后胸闷、气短3天的病史。随后，经胸超声心动图显示右心室内有一实性回声团块，伴有异常血流动力学改变。心脏计算机断层血管造影显示一个大的均匀密度充盈缺损，占据右心室大部分区域，且随心动周期搏动突出。随后的手术切除及组织学研究成功确诊，患者术后恢复过程顺利。
