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年轻患者的心脏副神经节瘤以心绞痛样症状为表现:病例报告及文献复习。

Cardiac Paraganglioma in a Young Patient Presents with Angina-like Symptoms: A Case Report and Literature Review.

机构信息

Division of Cardiovascular ICU, Department of Critical Care Medicine, Houston Methodist Hospital, Houston, TX 77030, USA.

Department of Cardiothoracic Surgery, Cincinnati Children's Hospital, Cincinnati, OH 45229, USA.

出版信息

Medicina (Kaunas). 2024 Sep 13;60(9):1495. doi: 10.3390/medicina60091495.

Abstract

Paragangliomas are rare extra-adrenal neuroendocrine tumors originating from chromaffin tissue that present a diagnostic and therapeutic challenge due to their diverse clinical manifestations and low incidence. While these tumors often manifest as catecholamine-secreting functional tumors, their clinical presentation can vary, leading to delayed diagnosis and challenging management. This study presents the case of a 22-year-old patient with cardiac paraganglioma who initially presented with angina-like symptoms, highlighting the importance of considering this rare condition in young individuals with nonspecific complaints. Diagnostic imaging, including transthoracic echocardiography, CT angiography, and MRI, played a crucial role in identifying the tumor's location and vascularization. Surgical excision, including pulmonary artery graft and CABG, was the primary management approach, which was accompanied by intraoperative complications that later led to CCU admission, followed by postoperative complications, ultimately leading to the patient's death. This case highlights the significance of early recognition and management of complications following a surgical approach to treat paragangliomas.

摘要

副神经节瘤是起源于嗜铬组织的罕见肾上腺外神经内分泌肿瘤,由于其临床表现多样且发病率低,因此具有诊断和治疗上的挑战。虽然这些肿瘤通常表现为儿茶酚胺分泌功能性肿瘤,但它们的临床表现可能有所不同,导致诊断延迟和治疗困难。本研究报告了一例 22 岁的心脏副神经节瘤患者,其最初表现为类似心绞痛的症状,强调了在有非特异性症状的年轻个体中考虑这种罕见疾病的重要性。诊断性影像学检查,包括经胸超声心动图、CT 血管造影和 MRI,在确定肿瘤的位置和血管化方面发挥了关键作用。手术切除,包括肺动脉移植和 CABG,是主要的治疗方法,手术过程中出现了并发症,随后导致患者入住 CCU,随后出现术后并发症,最终导致患者死亡。这个病例强调了早期识别和处理手术治疗副神经节瘤后并发症的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69de/11434372/85f3ce788ebe/medicina-60-01495-g001.jpg

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