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原发性心脏内平滑肌瘤:罕见病例报告及文献复习。

Primary intracardiac leiomyoma: rare case report and literature review.

机构信息

Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, P.O. BOX 80205, 21589, Jeddah, Saudi Arabia.

Department of Cardiovascular, Cardiac Surgery Section, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.

出版信息

J Cardiothorac Surg. 2024 Sep 28;19(1):547. doi: 10.1186/s13019-024-03083-1.

Abstract

Benign cardiac neoplasms are relatively uncommon. Cardiac leiomyomas are usually diagnosed as a benign metastasizing leiomyoma or as a part of intravenous leiomyomatosis spectrum. Primary cardiac leiomyomas are extremely rare and should be diagnosed after ruling out the involvement of systemic leiomyomas. Only nine cases were found in the literature that described De novo occurrence of primary intra-cardiac leiomyoma. In this study, we present a case of 60-year-old female patient with a large pedunculated mass located in the left ventricle. Histopathology examination and immunohistochemistry aid confirmed the diagnosis of benign leiomyoma. No evidence of extra cardiac lesions was detected in the patient. The patient remained healthy with no signs of recurrence four years after the surgical resection. Benign cardiac tumors are not often seen, but when they do occur, they can present a serious risk to life. This is particularly significant because these tumors can detach and cause embolization, leading to the development of strokes. Moreover, these individuals do not show any clinical symptoms, making their detection quite challenging. When there is a suspicion, it is advised to utilize echocardiography and other imaging techniques to verify the presence of a tumor. In this report, we present a rare case and provide differential diagnoses, along with a review of the literature.

摘要

良性心脏肿瘤较为少见。心脏平滑肌瘤通常被诊断为良性转移性平滑肌瘤,或作为静脉内平滑肌瘤病谱的一部分。原发性心脏平滑肌瘤极为罕见,应在排除系统性平滑肌瘤受累后作出诊断。文献中仅发现 9 例描述新发生的原发性心脏内平滑肌瘤。本研究报道了 1 例 60 岁女性患者,其左心室有一个大的带蒂肿块。组织病理学检查和免疫组织化学辅助检查有助于明确良性平滑肌瘤的诊断。在患者体内未发现心脏外病变的证据。手术后 4 年,患者仍然健康,没有复发迹象。良性心脏肿瘤并不常见,但当它们发生时,会对生命构成严重威胁。这一点尤为重要,因为这些肿瘤可能会脱落并导致栓塞,从而引发中风。此外,这些患者没有任何临床症状,因此很难发现。当怀疑有肿瘤时,建议使用超声心动图和其他影像学技术来证实肿瘤的存在。在本报告中,我们介绍了 1 例罕见病例,并提供了鉴别诊断,并对文献进行了回顾。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/676b/11437805/ce8e06461f14/13019_2024_3083_Fig1_HTML.jpg

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