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结节性硬化症中的罕见成人期心脏横纹肌瘤:一例报告

Unusual adult-onset cardiac rhabdomyomas in tuberous sclerosis complex: a case report.

作者信息

Nati-Castillo H A, Quintero Juan Manuel, Molina Oswaldo Aguilar, Arias-Intriago Marlon, Melgar Muñoz Fernando P, Izquierdo-Condoy Juan S

机构信息

Interinstitutional Internal Medicine Group (GIMI 1), Department of Internal Medicine, Universidad Libre, Cali, Colombia.

Department of Internal Medicine, Universidad del Valle, Cali, Colombia.

出版信息

Front Med (Lausanne). 2024 Jul 31;11:1386089. doi: 10.3389/fmed.2024.1386089. eCollection 2024.

Abstract

BACKGROUND

Tuberous sclerosis complex is a genetic neurocutaneous autosomal dominant syndrome, characterized by the development of multiple benign tumors (hamartomas) affecting various systems. Heart-benign tumors that result from the complex are called cardiac rhabdomyomas. Unlike hamartomas that occur in other organs, cardiac rhabdomyomas are most prevalent in infants and very young children with tuberous sclerosis complex. We present a case of a young adult with tuberous sclerosis who had an unusually late diagnosis of cardiac rhabdomyomas.

CASE REPORT

A 22-year-old male patient of Afro-descendant, diagnosed with tuberous sclerosis complex in childhood, presented with refractory epilepsy and was treated only with lacosamide. The patient came to medical consultation due to a recent history of episodic, persistent chest pain in the sternal region, associated with physical effort. Echocardiography revealed a non-dilated left ventricle, with several rounded masses of high echogenicity without pedicles at the apical level, the largest measuring 14 × 11 mm, consistent with cardiac rhabdomyomas.

CONCLUSION

Cardiac rhabdomyomas rarely develop in adulthood for individuals with tuberous sclerosis. These late-onset cases can exhibit various symptoms, from simple to complex presentations. Regular clinical checkups are essential for adults with tuberous sclerosis complex.

摘要

背景

结节性硬化症是一种遗传性神经皮肤常染色体显性综合征,其特征是在多个系统中出现多发性良性肿瘤(错构瘤)。由该综合征导致的心脏良性肿瘤称为心脏横纹肌瘤。与发生在其他器官的错构瘤不同,心脏横纹肌瘤在患有结节性硬化症的婴儿和幼儿中最为常见。我们报告一例患有结节性硬化症的年轻成年人,其心脏横纹肌瘤的诊断异常延迟。

病例报告

一名22岁的非裔男性患者,童年时被诊断为结节性硬化症,患有难治性癫痫,仅接受拉科酰胺治疗。该患者因近期出现胸骨区域发作性、持续性胸痛且与体力活动有关前来就医。超声心动图显示左心室未扩张,心尖水平有几个无蒂的高回声圆形肿块,最大的尺寸为14×11毫米,符合心脏横纹肌瘤。

结论

对于患有结节性硬化症的个体,心脏横纹肌瘤在成年期很少发生。这些迟发性病例可表现出从简单到复杂的各种症状。对于患有结节性硬化症的成年人,定期进行临床检查至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0188/11322118/344f58b9cecf/fmed-11-1386089-g001.jpg

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