卡尼综合征患者迅速发展为巨大心脏黏液瘤1例报告

Messi P, Benzoni G, B. G., Fatti L, H. F., Badano L, Fratianni G, Moneta A, Donatelli F
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摘要

卡尼复杂综合征是一种罕见的遗传性疾病,会影响多个器官和系统,包括内分泌腺、心脏和皮肤。该综合征的传播是常染色体显性的,参与突变的基因,在60%以上的病例中,是PRKAR1A基因。我们的目标是介绍一位38岁的女性,自2011年以来被诊断为卡尼综合征。2022年4月,根据心脏筛查计划,她接受了经胸超声心动图检查,未发现任何心脏肿瘤。然而,在2022年12月,患者报告了呼吸困难和心悸等症状。立即行新的经胸超声心动图,发现左心房有一个大的椭圆形肿块,回声不均匀,边缘不规则,在房间隔处有一个宽的植入基部,尺寸为5 × 5,5 cm。肿块在左心室收缩,导致充盈受阻。此外,PFO,常见的解剖变异的房间隔,被发现。几天后,患者接受了心胸外科手术切除黏液瘤,并通过右小开胸术关闭PFO。手术成功,患者后续随访效果良好。在这篇文章中,我们的目的是关注在短时间内对有黏液瘤病史的患者进行超声心动图随访的必要性,以保护患者免于主要依从性,特别是降低心源性猝死的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Rapid Development of a Giant Cardiac Myxoma in a Patient with Carney syndrome: a Case Report
Carney Complex Syndrome is a rare genetic disorder that affects multiple organs and systems, including the endocrine glands, heart, and skin. The transmission of the syndrome is autosomal dominant, the gene involved in the mutation, in more than 60% of cases, is the PRKAR1A gene. We aim to present a 38-year-old female diagnosed with Carney syndrome since 2011. During April 2022, according to the cardiac screening plan, she underwent a transthoracic echocardiography, which did not show any cardiac tumors. However, in December 2022, the patient reported symptoms like dyspnea and palpitations. Immediately a new transthoracic echocardiography was performed, which revealed a large oval mass with heterogeneous echotexture and irregular margins in the left atrium, with a broad base of implantation at the interatrial septum, measuring 5 × 5, 5 cm. The mass cause obstruction to filling because was engaging in systole in the left ventricle. Additionally, a PFO, a common anatomical variant of interatrial septum, was found. The patient underwent cardiothoracic surgery to remove the myxoma and close the PFO via right mini thoracotomy, few days after. The surgery was successful, and the patient had good results in subsequent follow-up. In this article we aim to focus attention on the need to perform echocardiographic follow-up in a short time in patient with a familiar history of neoplasm involving myxoma, to preserve the patient from major compliances, especially reduce the risk of sudden cardiac death.
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