Takahashi T, Hada Y, Sakamoto T, Takenaka K, Amano K, Yamaguchi T, Ishimitsu T, Takahashi H
J Cardiogr. 1982 Jun;12(2):535-43.
A case of recurrent multiple cardiac myxomas was presented. The patient was a 27-year-old housewife. Four years ago, she underwent urgent resection of a left atrial myxoma and replacement of the interatrial septum with a patch graft by right atrial approach. The tumor was very friable and a part of the tumor dropped into cardiac chambers during the operation, and immediately saline lavage and aspiration were performed. The recovery was uneventful. On March, 1981, she was readmitted to our hospital because of increasing dry cough. Two-dimensional echocardiography demonstrated abnormal masses in the right atrium, right ventricle, and left atrium. Open heart surgery revealed three independent tumors, which were successfully removed. All tumors were benign myxomas histologically. The patient returned to full-time housework again. A case of recurrent multiple myxomas has not been previously reported. The recurrence of the myxoma in our case is thought to be caused by implantation of tumor cells during the initial operative procedure. Our case will suggest the malignant potentiality of cardiac myxoma. The necessity of radical excision and gentle handling of the tumor during the operation are reemphasized. Postoperative follow-up study is also mandatory for early detection of the recurrence of this potentially malignant neoplasm.
本文报告一例复发性多发性心脏黏液瘤病例。患者为一名27岁的家庭主妇。四年前,她接受了紧急手术,切除左心房黏液瘤,并通过右心房途径用补片移植替换房间隔。肿瘤非常脆弱,术中部分肿瘤掉入心腔,随即进行了生理盐水冲洗和抽吸。术后恢复顺利。1981年3月,因干咳加重,她再次入住我院。二维超声心动图显示右心房、右心室和左心房有异常肿块。心脏直视手术发现三个独立的肿瘤,并成功切除。所有肿瘤组织学检查均为良性黏液瘤。患者再次恢复全职家务。此前尚未报道过复发性多发性黏液瘤病例。我们病例中的黏液瘤复发被认为是由于初次手术过程中肿瘤细胞的种植所致。我们的病例提示心脏黏液瘤可能具有恶性潜能。再次强调手术中彻底切除肿瘤和轻柔操作的必要性。术后随访研究对于早期发现这种潜在恶性肿瘤的复发也至关重要。