Idiopathic cardiac ossification with Chiari mesh in the right atrium: a case report and literature review.

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL AME Case Reports Pub Date : 2024-04-17 eCollection Date: 2024-01-01 DOI:10.21037/acr-23-168
Menghan Zheng, Dong Chen, Jiaqi Wang, Jianfeng Shang, Fang Dong
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Abstract

Background: Idiopathic cardiac osseous metaplasia in the right atrium of a 9-year-old boy, accompanied by right atrial Chiari network and right pulmonary artery embolism. This case is rare and can easily be misdiagnosed.

Case description: We encountered a case of a 9-year-old boy with a 3.5 cm diameter neoplasm in the right atrium. Preoperative imaging diagnosis could not determine the nature of the tumor, and the initial clinical suspicion of cardiac myxoma. After admission, a cardiotomy to remove foreign bodies and a pulmonary artery thrombectomy were performed.

Conclusions: Idiopathic cardiac osseous metaplasia is relatively rare, and it is even rarer to be accompanied by a Chiari network in the right atrium. Due to the location and characteristics of the lesion in this case, it is easy to be misdiagnosed as atrial myxoma in clinical practice. Whether it is idiopathic osseous metaplasia or myxoma, it needs to be performed surgical treatment and pathological examination can easily rule out the diagnosis of myxoma. However, as idiopathic cardiac metaplasia is difficult to encounter in clinical work and there are few reports in the literature, clinicians and pathologists need to consult more relevant literature. Learn to understand and master the disease through multi-party consultation.

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特发性心脏骨化伴右心房Chiari网:病例报告和文献综述。
背景:一名 9 岁男孩的右心房出现特发性心脏骨质增生,并伴有右心房 Chiari 网络和右肺动脉栓塞。这种病例非常罕见,很容易被误诊:我们接诊了一例右心房内有一个直径 3.5 厘米肿瘤的 9 岁男孩。术前影像诊断无法确定肿瘤性质,临床初步怀疑为心脏肌瘤。入院后,进行了心脏切开取异物手术和肺动脉血栓切除术:特发性心脏骨化瘤相对罕见,而伴有右心房Chiari网的情况则更为罕见。由于本病例中病变的位置和特点,在临床实践中很容易被误诊为心房肌瘤。无论是特发性骨赘还是肌瘤,都需要进行手术治疗,病理检查很容易排除肌瘤的诊断。然而,由于特发性心肌变性在临床工作中很难遇到,文献报道也很少,临床医生和病理学家需要查阅更多相关文献。通过多方会诊,了解和掌握疾病。
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