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酷似冠状动脉瘤的右心室副神经节瘤:诊断难题

Right Ventricular Paraganglioma Mimicking Coronary Artery Aneurysm: A Diagnostic Conundrum.

作者信息

Kim Do Young, Azarkhail Ryan, Shah Parth, Alkhatib Deya, Jenkins William Travis, Anand Usha, Prasad Rajnish

机构信息

Department of Medicine, Wellstar Kennestone Regional Medical Center, Marietta, Georgia, USA.

Department of Medicine, Wellstar Kennestone Regional Medical Center, Marietta, Georgia, USA.

出版信息

JACC Case Rep. 2025 Sep 3;30(26):104892. doi: 10.1016/j.jaccas.2025.104892.

Abstract

BACKGROUND

Paragangliomas are rare neuroendocrine tumors arising from chromaffin cells, often associated with excess catecholamine production. Cardiac paragangliomas are particularly uncommon, accounting for <1% of all cardiac tumors.

CASE SUMMARY

We report a case of a right ventricular mass that was initially misidentified as a pericardial cyst on imaging but was ultimately diagnosed as a benign paraganglioma deriving from hereditary paraganglioma and pheochromocytoma syndrome after further diagnostic evaluation and treatment.

DISCUSSION

This case highlights how rare pathologies may mimic other conditions, emphasizing the complexity and importance of a thorough diagnostic work-up in identifying cardiac paragangliomas.

TAKE-HOME MESSAGES: Cardiac paragangliomas are exceptionally rare tumors that can mimic more common cardiac pathologies, making diagnosis challenging. Multimodal evaluation and broad differential diagnosis are essential in evaluating cardiac masses, especially when initial findings are inconclusive or suggest alternative diagnoses.

摘要

背景

副神经节瘤是起源于嗜铬细胞的罕见神经内分泌肿瘤,常伴有儿茶酚胺分泌过多。心脏副神经节瘤尤为罕见,占所有心脏肿瘤的比例不到1%。

病例摘要

我们报告一例右心室肿物病例,该肿物在影像学上最初被误诊为心包囊肿,但经过进一步诊断评估和治疗后,最终被诊断为源自遗传性副神经节瘤和嗜铬细胞瘤综合征的良性副神经节瘤。

讨论

该病例突出了罕见病理情况如何可能模仿其他病症,强调了在识别心脏副神经节瘤时进行全面诊断检查的复杂性和重要性。

要点

心脏副神经节瘤是极其罕见的肿瘤,可模仿更常见的心脏病症,这使得诊断具有挑战性。在评估心脏肿物时,多模式评估和广泛的鉴别诊断至关重要,尤其是当初始检查结果不确定或提示其他诊断时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ad3/12426667/fbacb41f5d27/ga1.jpg

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