Makam Rishab, Balaji Ayush, Balaji Akshay, Ravishankar Ramanish, Bocchetta Natasha, Sherif Mohamed, Loubani Mahmoud
Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, GBR.
Department of Medicine, Hull York Medical School, Hull, GBR.
Cureus. 2024 Nov 26;16(11):e74487. doi: 10.7759/cureus.74487. eCollection 2024 Nov.
This case report describes a rare instance of massive right ventricular myxoma (RVM). A 36-year-old woman initially presented with progressive breathlessness and chest heaviness. Imaging revealed a large mass in the mediastinum, which was initially thought to be a pericardial cyst, and it was unclear whether the mass was intracardiac or extracardiac. Extensive investigations and multiple discussions concluded that the mass was a right ventricular mass. Intraoperatively, the mass was confirmed to be in the right ventricle (RV), with involvement of the chordae tendineae and an extremely thinned-out right ventricular free wall. Surgical excision of the tumour from the RV, tricuspid valve repair, and plication of the free wall were performed, leading to significant symptomatic relief. The mass was identified as a myxoma through histological diagnosis. This case highlights the diagnostic challenges and management strategies for RVM.
本病例报告描述了一例罕见的巨大右心室黏液瘤(RVM)。一名36岁女性最初表现为进行性呼吸困难和胸部沉重感。影像学检查发现纵隔内有一个大肿块,最初认为是心包囊肿,且不清楚该肿块是心内还是心外的。经过广泛检查和多次讨论,得出该肿块是右心室肿块的结论。术中证实肿块位于右心室(RV),累及腱索且右心室游离壁极度变薄。对右心室肿瘤进行了手术切除、三尖瓣修复以及游离壁折叠术,症状得到显著缓解。通过组织学诊断确定该肿块为黏液瘤。本病例突出了RVM的诊断挑战和管理策略。