Cardiac myxoma with high standardized uptake value of FDG-PET-CT in the right ventricular outflow tract.

Hiroo Uehara, Kenta Ohba, Makoto Ono, Tomohiro Imazuru, Tomoki Shimokawa
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Abstract

Background: Cardiac myxoma rarely occurs in the right ventricle, and as is a benign disease, it rarely shows high positivity on 18F fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT).

Case presentation: We present herein the case of a 77-year-old woman who was found to have a heart murmur during a routine health checkup. Further examination revealed a 27-mm tumor in the right ventricular outflow tract (RVOT) and moderate aortic valve stenosis. Additionally, during her preoperative evaluation, she was diagnosed with a 10-mm tumor in the right breast, prompting her referral to our hospital for further evaluation and treatment. Contrast-enhanced CT and magnetic resonance imaging of the chest did not show signs strongly suggestive of malignancy, nor did echocardiography. However, FDG-PET/CT showed an abnormally high standardized uptake value (SUV) max of 9.91. Based on these findings, we decided the best treatment course was tumor resection of the RVOT and aortic valve replacement. Our intraoperative examination confirmed a tumor inferior to the pulmonary valve; therefore, we resected three branches of the septal artery feeding the tumor, including part of the right ventricular free wall. A rapid pathological examination indicated a benign tumor, and the patient's final diagnosis was a cardiac myxoma. The postoperative course was uneventful, and to date, workup including CT scans during follow-up has shown no obvious recurrence.

Conclusion: This case highlights the challenges and importance of accurate imaging diagnoses in cardiac tumors. The patient underwent a successful surgical resection of the cardiac myxoma, emphasizing the need for careful postoperative follow-up.

右心室流出道FDG-PET-CT高标准摄取值心脏黏液瘤。
背景:心脏黏液瘤很少发生在右心室,作为一种良性疾病,在18F氟脱氧葡萄糖(FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)上很少显示高阳性。病例介绍:我们在此报告一位77岁的女性,在常规健康检查中发现心脏杂音。进一步检查发现右心室流出道(RVOT)有一个27毫米的肿瘤和中度主动脉瓣狭窄。此外,在术前检查中,她被诊断为右乳房10毫米肿瘤,促使她转诊到我们医院进一步评估和治疗。胸部增强CT和磁共振成像未显示强烈提示恶性肿瘤的征象,超声心动图也未显示。然而,FDG-PET/CT显示异常高的标准化摄取值(SUV)最大值为9.91。基于这些发现,我们决定最好的治疗方案是肿瘤切除RVOT和主动脉瓣置换术。术中检查证实一肿瘤位于肺动脉瓣下方;因此,我们切除了供血肿瘤的三个间隔动脉分支,包括部分右心室游离壁。快速病理检查显示为良性肿瘤,最终诊断为心脏黏液瘤。术后过程平安无事,到目前为止,随访期间的随访包括CT扫描均未见明显复发。结论:本病例强调了心脏肿瘤准确影像学诊断的挑战和重要性。患者接受手术成功切除心脏黏液瘤,强调需要仔细的术后随访。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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