原位心脏移植术后出现伴有PIK3CA突变的肺动脉肿物。
Pulmonary artery mass with PIK3CA mutation after orthotopic heart transplantation.
作者信息
Son Andre Y, Clark Aaron J, Alexiev Borislav A, Pham Duc Thinh
机构信息
Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine and Northwestern Medicine, 676 N St Clair Street Suite 730, Chicago, IL, 60611-2968, USA.
Department of Pathology, Feinberg School of Medicine, Northwestern University, Evanston, USA.
出版信息
J Cardiothorac Surg. 2024 Oct 1;19(1):558. doi: 10.1186/s13019-024-03090-2.
BACKGROUND
Patients can develop de novo malignancies following orthotopic heart transplantation. However, vascular tumors are not commonly described in this population.
CASE PRESENTATION
We present a 69-year-old female with a history of orthotopic heart transplantation for chemotherapy-induced cardiomyopathy who developed an incidental pulmonary artery mass six years after her transplantation. Given concerns for malignancy, the patient underwent an operative excisional biopsy through a left anterior mini-thoracotomy with femoral artery and vein cannulation for cardiopulmonary bypass. The mass was determined to be a non-malignant vascular overgrowth with PIK3CA mutation.
CONCLUSION
We present the case of an unusual pulmonary artery mass with PIK3CA mutation found in a post heart transplant patient. We were able to spare her the morbidity of a redo-sternotomy by excising the mass via a minimally invasive left anterior thoracotomy approach.
背景
原位心脏移植术后患者可发生新发恶性肿瘤。然而，该人群中血管肿瘤并不常见。
病例介绍
我们报告一名69岁女性，有因化疗所致心肌病接受原位心脏移植的病史，移植后6年偶然发现肺动脉肿物。鉴于对恶性肿瘤的担忧，患者接受了手术切除活检，通过左前小切口开胸，股动静脉插管进行体外循环。肿物被确定为伴有PIK3CA突变的非恶性血管过度生长。
结论
我们报告了一例心脏移植术后患者出现的伴有PIK3CA突变的罕见肺动脉肿物病例。我们通过微创左前开胸入路切除肿物，避免了患者再次行胸骨切开术的并发症。
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