Simic O, Strathausen S, Attarbaschi M, Bolte J
Abteilung für Herzchirurgie, Allgemeines Krankenhaus St. Georg, Hamburg.
Dtsch Med Wochenschr. 1996 Oct 25;121(43):1325-8. doi: 10.1055/s-2008-1043147.
A 32-year-old man of Albanian descent had for ten years been complaining of pain over the apex of the heart with gradually increasing dyspnoea. He was hospitalised because of an acute duodenal ulcer.
Clinical and biochemical examinations were within normal limits. Computed tomography and magnetic resonance imaging revealed a myocardial tumour in the right ventricle, 4 x 3 x 3 cm.
A primary myocardial tumour of unknown malignancy was suspected, but at surgery it was found to be an echinococcal cyst, which was resected. Echinococcal antigen titre, first measured postoperatively, was positive (ELISA and IHA tests). Albendazole was administered (50 mg/kg daily) to prevent recurrence. The patient was still symptom-free two years postoperatively.
Echinococcal cyst should be considered in the differential diagnosis of cardiac tumour. If untreated the condition may be fatal. Resection under cardiopulmonary bypass with cardioplegia, as in this patient, carries a low risk and is therefore the treatment of choice.
一名32岁的阿尔巴尼亚裔男子，十年来一直诉说心尖部疼痛，并伴有逐渐加重的呼吸困难。他因急性十二指肠溃疡入院。
临床及生化检查均在正常范围内。计算机断层扫描和磁共振成像显示右心室有一个4×3×3厘米的心肌肿瘤。
怀疑是原发性恶性不明的心肌肿瘤，但手术时发现是一个棘球蚴囊肿，将其切除。术后首次检测的棘球蚴抗原滴度呈阳性（酶联免疫吸附测定和间接血凝试验）。给予阿苯达唑（每日50毫克/千克）以预防复发。术后两年患者仍无症状。
在心脏肿瘤的鉴别诊断中应考虑棘球蚴囊肿。若不治疗，病情可能致命。像该患者一样在体外循环和心脏停搏下进行切除，风险较低，因此是首选治疗方法。
