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三尖瓣环毛细血管性血管瘤:一种罕见的表现。

Capillary haemangioma of the tricuspid valve annulus: A rare presentation.

作者信息

Ranjan Ashis, Agarwal Rajat, Singh Dharmendra

机构信息

Department of Cardiology, Govt TD Medical College, Alappuzha, India; All India Institute of Medical Sciences, Deoghar, India.

All India Institute of Medical Sciences, Deoghar, India.

出版信息

Int J Surg Case Rep. 2023 May;106:108171. doi: 10.1016/j.ijscr.2023.108171. Epub 2023 Apr 11.

Abstract

INTRODUCTION AND IMPORTANCE

To the best of our knowledge, very few tricuspid valves (TV) haemangiomas have been reported to date in the literature due to the avascular nature of the cardiac valve. We report the case of an otherwise healthy male presented with unexplained shortness of breath who was found to have tricuspid valvular haemangioma.

CASE PRESENTATION

52-year-old male who presented with progressive dyspnoea on exertion for 6 months. Echocardiography revealed an echo-dense mass attached to the heart's anterior leaflet of the tricuspid valve. A cardiac MRI suggested it as pulmonary fibroelastoma, but a surgical excision biopsy revealed it to be a capillary haemangioma. Patient symptoms improved after surgery.

CLINICAL DISCUSSION

Cardiac valve tumour-like haemangiomas are rare, with the involvement of the tricuspid valve even rarer. Most TV haemangiomas are detected incidentally, however, they may present with a range of symptoms. Echocardiography is the mainstay of diagnosis however definitive diagnosis is by histopathology. Surgical excision is the treatment of choice, though surgery in asymptomatic patients is still controversial.

CONCLUSION

Cardiac haemangiomas are rare, with the involvement of the tricuspid valve even rarer. They should undergo surgical excision due to the risks of embolism, rupture, and sudden death.

摘要

引言与重要性

据我们所知,由于心脏瓣膜的无血管特性,迄今为止,文献中报道的三尖瓣血管瘤非常少。我们报告一例原本健康的男性病例,该患者因不明原因的呼吸急促就诊,被发现患有三尖瓣血管瘤。

病例介绍

一名52岁男性,出现进行性劳力性呼吸困难6个月。超声心动图显示一个回声密集团块附着于三尖瓣的前叶。心脏磁共振成像提示为肺纤维弹性瘤,但手术切除活检显示为毛细血管瘤。术后患者症状改善。

临床讨论

心脏瓣膜肿瘤样血管瘤罕见,累及三尖瓣的情况更为罕见。大多数三尖瓣血管瘤是偶然发现的,然而,它们可能会出现一系列症状。超声心动图是诊断的主要手段,但确诊需依靠组织病理学。手术切除是首选治疗方法,不过对于无症状患者进行手术仍存在争议。

结论

心脏血管瘤罕见,累及三尖瓣的情况更为罕见。由于存在栓塞、破裂和猝死风险,应进行手术切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bbc/10149200/9e159f8eaf4c/gr1.jpg

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