RESUMO
Primary cardiac tumours are uncommon in the paediatric population, accounting for fewer than 0.5% of paediatric cases of cardiac disease. Right ventricular tumours, including myxomas, are particularly rare and may be asymptomatic or demonstrate varying degrees of cardiac dysfunction based on the location and size of the tumour, inducing conduction abnormalities, syncope, embolism, and potentially, sudden death. We report a rare case of right ventricular myxoma causing severe right ventricular outflow tract obstruction and surgical intervention in a paediatric patient.
RESUMO
BACKGROUND: Myxoma is an uncommon disease and its symptoms vary greatly depending on size, location and mobility. Right-sided myxoma, especially right ventricular myxoma, is much rarer, and the symptoms are alien and uncharacteristic. The lack of understandings poses challenges to prompt diagnosis and timely treatment. CASE PRESENTATION: A 44-year-old female patient was diagnosed with giant right ventricular tumor. Right heart failure and systemic congestion caused by right ventricular outflow tract obstruction were observed on this case. Surgery was performed to excise the mass which was measured at 9.5 * 5.0 cm and confirmed as myxoma pathologically. CONCLUSIONS: Right-side myxoma is easy to be unnoticed due to its low incident rate and atypical symptoms. Delay in surgical intervention might cause unrecoverable complications. More comprehensive understanding of the symptoms is expected to help improving the diagnose and treat of right-sided myxoma.
Assuntos
Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/cirurgia , Mixoma/complicações , Mixoma/cirurgia , Adulto , Feminino , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/cirurgia , Neoplasias Cardíacas/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/cirurgia , Humanos , Mixoma/diagnóstico por imagem , Doenças Raras , Resultado do TratamentoRESUMO
Right ventricular (RV) myxomas are extremely rare, but may have dreadful clinical sequelae including pulmonary embolism (PE). We present a case of a patient who had an RV myxoma that was attached to the tricuspid valve, and therefore could not be resected completely during surgery, and remnants of the tumor were seen on transthoracic echocardiogram during post-operative follow-up. Five months after surgery, the patient had PE, which could be due to tumor emboli or thromboemboli. Since repeat surgical resection was not feasible, the patient was started on warfarin. The patient is doing well and has had no PE recurrence over the past 20 months of follow-up. We have complemented the current case report with a comprehensive literature search and review on RV myxomas associated with PE in order to shed light on this uncommon but potentially lethal disorder. We concluded that right-sided cardiac myxomas, including RV myxomas, should be considered while dealing with PE, particularly in young patients with no risk factors, and that follow-up with echocardiography after surgery is important due to the possibility of recurrence, especially if complete resection was difficult to perform. Plain language summary available for this article.