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一名11岁女童患者发生血栓栓塞性中风合并双房黏液瘤的罕见病例:病例报告

A rare case of biatrial myxoma in an 11-year-old girl patient with thromboembolic stroke: A case report.

作者信息

Laksmono Navy, Tansa Chrisna Wariz, Karina Bela Ita, Anestya Nia, Agustina Hasrayati

机构信息

Cardiothoracic Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.

Cardiothoracic Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.

出版信息

Int J Surg Case Rep. 2025 Jun;131:111311. doi: 10.1016/j.ijscr.2025.111311. Epub 2025 Apr 17.

Abstract

INTRODUCTION

Cardiac myxomas (CM) are benign primary tumors typically found in the left atrium, but biatrial myxomas are exceptionally rare, comprising only 3-5 % of cases. This report highlights the rarity of biatrial myxomas in a young patient, the importance of early recognition due to the risk of thromboembolic events, which can lead to stroke. Excellent surgical intervention is needed to prevent CM recurrences.

CASE PRESENTATION

An 11-year-old girl presented with sudden onset of left-sided hemiparesis, aphasia, right-sided facial drooping, cephalgia, palpitations, nausea, and intermittent chest pain over the past two months. Laboratory examination revealed anemia and elevated D-Dimer. Echocardiography and cardiac CT demonstrated large masses in the right and left atrium, suggesting myxomas. The patient was diagnosed with biatrial myxomas complicated by thromboembolic stroke.

CLINICAL DISCUSSION

Complete mass evacuation was performed through median sternotomy. Histopathology examination confirmed CM.

CONCLUSION

This case emphasizes the importance of early detection, detailed examination and surgical intervention of biatrial myxomas, especially in young patients, to prevent and manage life-threatening thromboembolic complications and recurrence of CM. Timely intervention is crucial for ensuring favorable outcomes.

摘要

引言

心脏黏液瘤(CM)是一种良性原发性肿瘤,通常位于左心房,但双侧心房黏液瘤极为罕见,仅占病例的3 - 5%。本报告强调了年轻患者双侧心房黏液瘤的罕见性,以及由于血栓栓塞事件风险(可导致中风)而早期识别的重要性。需要出色的手术干预来预防CM复发。

病例介绍

一名11岁女孩在过去两个月中出现突然发作的左侧偏瘫、失语、右侧面部下垂、头痛、心悸、恶心和间歇性胸痛。实验室检查显示贫血和D - 二聚体升高。超声心动图和心脏CT显示右心房和左心房有大肿块,提示黏液瘤。该患者被诊断为双侧心房黏液瘤并发血栓栓塞性中风。

临床讨论

通过正中胸骨切开术进行了完整的肿块清除。组织病理学检查证实为CM。

结论

本病例强调了双侧心房黏液瘤早期检测、详细检查和手术干预的重要性,特别是对于年轻患者,以预防和处理危及生命的血栓栓塞并发症及CM复发。及时干预对于确保良好预后至关重要。

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