Cardiology Division, Saint Esprit Kaslik University USEK, Hospital Notre Dame des Secours, Saint Charbel Street- PO Box # 3, Byblos, 12345, Lebanon.
J Med Case Rep. 2023 Sep 21;17(1):403. doi: 10.1186/s13256-023-04130-6.
Myxomas are the most prevalent type of heart tumors, mainly occurring in the left atrium, with approximately 20% of cases found in the right atrium. Timely diagnosis and appropriate management of myxomas are crucial for favorable outcomes and to minimize complications.
A 77-year-old Asian male with no significant medical history presented with intermittent trepopnea and palpitations. Physical examination revealed regular heart sounds and no other relevant findings. A transthoracic echocardiogram showed a large, round-shaped, smooth-edged mass with diameter of 86 mm, occupying most of the right atrium. Mild tricuspid flow obstruction and mild left ventricular systolic dysfunction were also observed. Cardiac tomography confirmed the size, smooth edges, and showed microcalcifications of the mass, with no invasion of surrounding tissues. Surgical intervention successfully removed the spheroid mass, leading to the alleviation of symptoms. Histopathology confirmed the myxoma nature of the mass. A comprehensive discussion based on relevant medical literature is provided, with emphasis on echocardiographic characteristics of the mass with relation to potential embolic disease.
This case shows an atypical presentation of an exceptionally large myxoma in the right atrium, resembling the size of a polo ball, in a patient presenting with supraventricular arrhythmia and trepopnea. Early diagnosis and appropriate management played a vital role in achieving a successful outcome for the patient.
黏液瘤是最常见的心脏肿瘤类型，主要发生在左心房，约 20%的病例发生在右心房。及时诊断和适当的黏液瘤管理对于获得良好的结果和最小化并发症至关重要。
一名 77 岁的亚洲男性，无明显病史，表现为间歇性呼吸急促和心悸。体格检查显示心音规则，无其他相关发现。经胸超声心动图显示一个大的、圆形、边缘光滑的肿块，直径为 86 毫米，占据了右心房的大部分。还观察到三尖瓣轻度血流阻塞和左心室收缩功能轻度障碍。心脏计算机断层扫描证实了肿块的大小、光滑的边缘，并显示出肿块的微钙化，没有周围组织的侵犯。手术干预成功地切除了球形肿块，症状得到缓解。组织病理学证实了肿块的黏液瘤性质。根据相关医学文献进行了全面讨论，重点讨论了与潜在栓塞性疾病相关的肿块的超声心动图特征。
本例展示了一例非常大的右心房黏液瘤的非典型表现，其大小类似于马球，患者表现为室上性心律失常和呼吸急促。早期诊断和适当的治疗对患者的成功结局起着至关重要的作用。
