成人心肌内纤维瘤致室性心动过速 1 例，成功手术切除。
A rare case of ventricular tachycardia caused by an intramyocardial fibroma with successful surgical resection in an adult.
机构信息
Department of Cardiology, Virginia Tech Carilion Roanoke Memorial Hospital, 1906 Belleview Ave SE, Roanoke, VA, 24015, USA.
Department of Cardiothoracic Surgery, University of Virginia, Charlottesville, VA, USA.
出版信息
J Cardiothorac Surg. 2024 Sep 5;19(1):515. doi: 10.1186/s13019-024-02986-3.
BACKGROUND
Cardiac fibromas are extremely rare in adults. The preferred treatment is surgical resection, but antiarrhythmic medications or heart transplantation have also been used previously. The cardiac imaging, particularly MRI, can be useful to help delineate between primary cardiac tumors, and surgical factors such as the extent/size of the fibroma, involvement of the coronary arteries or mitral apparatus and amount of residual myocardium influence whether surgical resection is feasible.
CASE PRESENTATION
A 42-year-old male presented with a wide-complex tachycardia, unresponsive to amiodarone. An echocardiogram was performed which showed a possible posterior wall mass. A cardiac MRI showed a well circumscribed lateral wall intracardiac fibroma, measuring 5.2 × 5.1 × 3.8 cm with preserved function. Surgical resection was successful, and he was discharged without a defibrillator.
CONCLUSIONS
Cardiac fibromas are encapsulated tumors which do not infiltrate myocardium and should be surgically resected if possible.
背景
心脏纤维瘤在成年人中极为罕见。首选的治疗方法是手术切除，但以前也使用过抗心律失常药物或心脏移植。心脏成像，特别是 MRI，可以帮助区分原发性心脏肿瘤，以及手术因素，如纤维瘤的范围/大小、冠状动脉或二尖瓣装置的受累程度以及残留心肌的数量，这些因素都影响手术切除的可行性。
病例介绍
一名 42 岁男性因宽复合性心动过速就诊，胺碘酮治疗无效。行超声心动图检查显示可能存在后侧壁肿块。心脏 MRI 显示一个边界清楚的外侧壁心内纤维瘤，大小为 5.2×5.1×3.8cm，功能正常。手术切除成功，他出院时没有植入除颤器。
结论
心脏纤维瘤是有包膜的肿瘤，不会浸润心肌，如果可能的话，应通过手术切除。
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