Papestiev Vasil, Shokarovski Marjan, Lazovski Nikola, Mehmedovic Nadica, Andova Valentina, Petrushevska Gordana, Georgievska-Ismail Ljubica
University Clinic for Cardiac Surgery, Medical Faculty, Ss. Cyril and Methodius University of Skopje, Majka Tereza no. 17/building 8, Skopje 1000, Republic of North Macedonia.
University Clinic of Cardiology, Medical Faculty, Ss. Cyril and Methodius University of Skopje, Republic of North Macedonia, Majka Tereza no. 17/building 8, Skopje 1000, Republic of North Macedonia.
Radiol Case Rep. 2025 Feb 1;20(4):2075-2079. doi: 10.1016/j.radcr.2025.01.020. eCollection 2025 Apr.
Myxomas are cardiac neoplasms that are most commonly located in the left atrium, usually arising from the vicinity of the fossa ovalis. However, there have been cases, although very rarely, of valvular myxoma. A cardiac mass found incidentally on echocardiography can present a challenge in particular if asymptomatic or found in an unusual location. We present the case of a 58-year-old male with kidney disease treated with chronic dialysis, referred to the cardiology clinic because of an incidental finding of a mitral valvular mass on routine transthoracic echocardiography. Although this lesion was initially misdiagnosed as native valvular endocarditis with vegetation, a series of clinical and radiological investigations led to the preoperative diagnosis of possible papillary fibroelastoma or calcified thrombotic mass. Given the increased risk of embolization due to the mass being mobile and greater than 1 cm in size, the patient was referred to cardiac surgery. Excision of the mass without mitral valve replacement was performed. Histopathological findings of the mass revealed the existence of a cardiac myxoma. In such cases of a mitral valve mass, multimodality imaging should have of high priority to achieve an accurate diagnosis. Although a definitive diagnosis can only be established after surgical excision of the mass and histopathological confirmation, it is very important to consider a differential diagnosis of mitral valve myxoma in any patient with an unexplained mitral valve mass.
黏液瘤是最常见于左心房的心脏肿瘤，通常起源于卵圆窝附近。然而，尽管非常罕见，但也有瓣膜黏液瘤的病例。特别是当心脏肿物在超声心动图检查中偶然发现且无症状或位于不寻常位置时，可能会带来诊断挑战。我们报告一例58岁患有肾病并接受慢性透析治疗的男性患者，因在常规经胸超声心动图检查中偶然发现二尖瓣肿物而转诊至心脏病诊所。尽管该病变最初被误诊为伴有赘生物的原发性瓣膜性心内膜炎，但一系列临床和影像学检查最终在术前诊断为可能的乳头状纤维弹性瘤或钙化血栓性肿物。鉴于肿物活动且大小大于1 cm导致栓塞风险增加，该患者被转诊至心脏外科。在未进行二尖瓣置换的情况下切除了肿物。肿物的组织病理学检查结果显示为心脏黏液瘤。在二尖瓣肿物的此类病例中，多模态成像对于准确诊断至关重要。虽然只有在肿物手术切除并经组织病理学证实后才能确立明确诊断，但对于任何患有无法解释的二尖瓣肿物的患者，考虑二尖瓣黏液瘤的鉴别诊断非常重要。
