Mukasa Kotaro, Abe Shinichiro, Yakita Yasunori, Asano Soichi
Department of Cardiovascular Surgery, Chiba Cardiovascular Center, Ichihara, JPN.
Cureus. 2025 Jun 29;17(6):e86984. doi: 10.7759/cureus.86984. eCollection 2025 Jun.
Frank's sign, a diagonal earlobe crease linked to atherosclerotic disease, remains poorly understood, and no association with cardiac tumors has been reported. We describe the case of a 68-year-old man who presented with exertional dyspnea and an elevated N-terminal pro-B-type natriuretic peptide level of 2,251 pg/mL. Transthoracic echocardiography identified a 75 mm × 50 mm pedunculated mass in the right atrium that prolapsed toward the tricuspid valve. Frank's sign was present bilaterally despite the absence of coronary or peripheral arterial disease. Contrast-enhanced CT confirmed attachment of a gelatinous mass to the atrial free wall, and coronary CT angiography demonstrated no stenosis. The tumor was excised via median sternotomy under cardiopulmonary bypass established with aorto-superior vena cava cannulation, supplemented by a femoral venous cannula to facilitate inferior vena cava drainage. Histology showed spindle cells in a myxoid matrix without atypia, consistent with benign myxoma. To our knowledge, this is the first report describing the coexistence of Frank's sign and cardiac myxoma. We speculate that tumor-derived cytokines such as interleukin-6 and vascular endothelial growth factor might impair earlobe microcirculation; however, coincidental coexistence cannot be excluded.
弗兰克氏征是一种与动脉粥样硬化疾病相关的耳垂斜向皱纹，目前人们对其了解甚少，且尚未有与心脏肿瘤相关联的报道。我们报告一例68岁男性病例，该患者表现为劳力性呼吸困难，N末端B型利钠肽前体水平升高至2251 pg/mL。经胸超声心动图检查发现右心房有一个75 mm×50 mm的带蒂肿物，该肿物向三尖瓣脱垂。尽管该患者没有冠状动脉或外周动脉疾病，但双侧均出现了弗兰克氏征。增强CT证实一个凝胶状肿物附着于心房游离壁，冠状动脉CT血管造影显示无狭窄。在通过主动脉 - 上腔静脉插管建立体外循环并辅以股静脉插管以促进下腔静脉引流的情况下，经正中胸骨切开术切除肿瘤。组织学检查显示在黏液样基质中有梭形细胞，无细胞异型性，符合良性黏液瘤。据我们所知，这是第一份描述弗兰克氏征与心脏黏液瘤并存的报告。我们推测肿瘤来源的细胞因子如白细胞介素 - 6和血管内皮生长因子可能会损害耳垂微循环；然而，也不能排除二者巧合并存的可能性。
