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題名 | Right Atrial Myxoma with a Huge Feeding Artery Mimicking a Coronary Arterial Fistula--A Case Report=疑似冠狀動脈廔管的心房黏液瘤巨大供應血管--一病例報告 |
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作者 | 楊登文; 彭明正; 郭靖海; 侯嘉殷; 周友三; 蔡正河; | 書刊名 | Acta Cardiologica Sinica |
卷期 | 13:4 民86.10-12 |
頁次 | 頁209-213 |
分類號 | 415.3161 |
關鍵詞 | 心房黏液瘤; 冠狀動脈廔管; 食道超音波; Coronary arterial fistula; Atrial myxoma; Transesophageal echocardiography; |
語文 | 英文(English) |
中文摘要 | 心房粘液瘤常存在其腫瘤供應血管,佰有很少數的腫瘤供應血管特別粗 大,甚至大到從超音波下即可見,會令人以為是冠狀動脈�硎煄C 病例報告:一位76歲男性,因進行性呼吸急促及下肢水腫到院求診,胸部X光 發現心藏部位有巨大的鈣化陰影,食道超音波發現右心房內有一約6公分立方 富含心管的腫瘤,併有疑似冠狀動脈�硎煄C心導管檢查,右冠狀動脈開口附近 有一直徑約7公厘的血管灌流至此腫瘤內,開刀證實此為黏液瘤,併有粗大的 腫瘤供應血管。 結論:雖然心房黏液瘤的供應血管通常是細小的,但極少數會長的特別粗大, 臨床上應與冠狀動脈�硎犑@鑑別。此外,富含血管的心臟腫瘤,也可能是黏液 瘤,臨床上應特別注意。 |
英文摘要 | Background. Atrial myxomas are usually supplied by clusters of small and tortuous vessels, but few of these feeding vessels may present as large arteries which mimic the pattern of coronary arterial fistula. Case report. The case is presented of a 76-year-old male patient with a right atrial myxoma associated with a huge feeding artery demonstrated on transesophageal echocardiography (TEE) as a strong color Doppler flow signal inside the tumor. Subsequent coronary angiography showed that the corresponding color Doppler signal on TEE was caused by a huge tumor- feeding artery originating from the right coronary artery orifice and mimicking coronary arterial fistula. The diameter of the feeding artery reached 7 mm with clear tumor stain demonstrated on the late phase of arteriography. Surgical findings confirmed the nature of the tumor to be a right atrial myxoma supplied by a huge feeding artery. Conclusion. Although the prevalence of angiographically visible tumor vascaularity is reported to be around 40%, few of these feeding arteries reach such a large size as to render them visible on TEE:Atrial myxomas with gigantic tumor feeding artery should be listed as one of the possibilities for differential diagnosis among intracardiac masses associated with strong Doppler flow signals. |
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