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右心房心脏钙化性无定形肿瘤:一种罕见的心脏肿瘤。

Cardiac calcified amorphous tumor in the right atrium: a rare cardiac neoplasm.

作者信息

Fu Wentao, Liu Kun, Zhang Yan, Wang Jing, Cai Wan, Wu Yaoyao, Chi Hao, Ge Wen

机构信息

Department of Cardiothoracic Surgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Department of Pathology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

出版信息

J Cardiothorac Surg. 2025 Jul 9;20(1):288. doi: 10.1186/s13019-025-03501-y.

Abstract

BACKGROUND

Cardiac calcified amorphous tumors (CATs) represent rare, nonneoplastic intraluminal heart masses, with limited case reports in existing literature. Asymptomatic cases localized in the right atrium are particularly unusual.

CASE PRESENTATION

An asymptomatic 46-year-old male was discovered to have a cardiac mass upon echocardiograph. Echocardiography revealed a 13.2 × 11.8 mm pedunculated mass in the right atrium, attached to the interatrial septum. Then we performed surgical treatment. Histopathology revealed some myocardial tissue, a powdery stained, calcified amorphous area, and a few localized lymphocytes and red blood cells. The final diagnosis confirmed a cardiac CAT.

CONCLUSIONS

CATs, rarely occurring endocardium-based pseudotumors, comprise calcium nodules and amorphous fibrin material. Typically presenting as a calcified pedunculated mass, they may arise in any heart chamber, with a significant propensity for distal embolism. Differentiating CATs from calcified atrial myxomas, calcified thrombi, or other cardiac tumors is challenging. Histopathology remains a critical diagnostic cornerstone. Although complete surgical resection is the recommended treatment, anticoagulation and ongoing surveillance may serve as viable alternatives when primary treatment, surgical resection, is deemed excessively hazardous.

摘要

背景

心脏钙化性无定形肿瘤(CATs)是一种罕见的非肿瘤性心腔内肿块,现有文献中的病例报道有限。位于右心房的无症状病例尤为罕见。

病例介绍

一名46岁无症状男性在超声心动图检查时发现心脏有肿块。超声心动图显示右心房有一个13.2×11.8毫米的带蒂肿块,附着于房间隔。随后我们进行了手术治疗。组织病理学检查发现一些心肌组织、一个呈粉末状染色的钙化无定形区域以及少量局部淋巴细胞和红细胞。最终诊断为心脏CATs。

结论

CATs是罕见的起源于心内膜的假肿瘤,由钙结节和无定形纤维蛋白物质组成。通常表现为钙化带蒂肿块,可发生于任何心腔,有显著的远端栓塞倾向。将CATs与钙化性心房黏液瘤、钙化血栓或其他心脏肿瘤区分开来具有挑战性。组织病理学仍然是关键的诊断基石。尽管推荐的治疗方法是完全手术切除,但当主要治疗方法(手术切除)被认为风险过高时,抗凝治疗和持续监测可能是可行的替代方案。

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