{"title":"伴二尖瓣环钙化的钙化性无定形肿瘤快速生长:病例报告。","authors":"Satoki Ozoe, Yutaka Koyama, Masahiro Inagaki, Shinji Tomita","doi":"10.1186/s44215-024-00164-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Calcified amorphous tumor (CAT) of the heart is a rare, non-neoplastic cardiac mass with mitral valves and annuli being the most common sites. The presence of mitral annular calcification (MAC) is associated with an increased risk of stroke or other systemic embolisms. Here, we report a case of CAT showing rapid growth with MAC and investigate the link between the two.</p><p><strong>Case presentation: </strong>A 71-year-old man presented at our hospital with dyspnea and had been undergoing hemodialysis for 26 years for chronic glomerulonephritis. Transthoracic echocardiography (TTE) revealed moderate mitral stenosis with bulky MAC. Two months later, the patient developed progressive dyspnea, and follow-up TTE revealed a highly mobile mass (8 × 5 mm) attached to the left ventricular (LV) side of the posterior MAC. He underwent surgery because of congestive heart failure and a high risk of embolization. Surgical inspection revealed that the tumor was attached beneath the P3 segment of the mitral valve on the LV side and was removed. When removing the MAC, toothpaste-like contents drained from the encapsulated mass inside the MAC at the P3 segment, where the tumor was located. After reconstructing the posterior mitral annulus defect with a bovine pericardial patch, mitral valve replacement with a mechanical prosthesis, a maze procedure, and left appendage closure were performed. Histopathological examination revealed that the excised tumor contained fibrin and calcium deposits. The mass was diagnosed as a CAT.</p><p><strong>Conclusions: </strong>CAT may be one of the causes of stroke induced by MAC. Routine follow-up echocardiography should be recommended for patients with MAC, especially those undergoing hemodialysis.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"3 1","pages":"39"},"PeriodicalIF":0.0000,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533609/pdf/","citationCount":"0","resultStr":"{\"title\":\"Rapid growth of calcified amorphous tumor with mitral annulus calcification: a case report.\",\"authors\":\"Satoki Ozoe, Yutaka Koyama, Masahiro Inagaki, Shinji Tomita\",\"doi\":\"10.1186/s44215-024-00164-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Calcified amorphous tumor (CAT) of the heart is a rare, non-neoplastic cardiac mass with mitral valves and annuli being the most common sites. The presence of mitral annular calcification (MAC) is associated with an increased risk of stroke or other systemic embolisms. Here, we report a case of CAT showing rapid growth with MAC and investigate the link between the two.</p><p><strong>Case presentation: </strong>A 71-year-old man presented at our hospital with dyspnea and had been undergoing hemodialysis for 26 years for chronic glomerulonephritis. Transthoracic echocardiography (TTE) revealed moderate mitral stenosis with bulky MAC. Two months later, the patient developed progressive dyspnea, and follow-up TTE revealed a highly mobile mass (8 × 5 mm) attached to the left ventricular (LV) side of the posterior MAC. He underwent surgery because of congestive heart failure and a high risk of embolization. Surgical inspection revealed that the tumor was attached beneath the P3 segment of the mitral valve on the LV side and was removed. When removing the MAC, toothpaste-like contents drained from the encapsulated mass inside the MAC at the P3 segment, where the tumor was located. After reconstructing the posterior mitral annulus defect with a bovine pericardial patch, mitral valve replacement with a mechanical prosthesis, a maze procedure, and left appendage closure were performed. Histopathological examination revealed that the excised tumor contained fibrin and calcium deposits. The mass was diagnosed as a CAT.</p><p><strong>Conclusions: </strong>CAT may be one of the causes of stroke induced by MAC. Routine follow-up echocardiography should be recommended for patients with MAC, especially those undergoing hemodialysis.</p>\",\"PeriodicalId\":520286,\"journal\":{\"name\":\"General Thoracic and Cardiovascular Surgery Cases\",\"volume\":\"3 1\",\"pages\":\"39\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-08-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533609/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"General Thoracic and Cardiovascular Surgery Cases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s44215-024-00164-4\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"General Thoracic and Cardiovascular Surgery Cases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s44215-024-00164-4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:心脏钙化无定形瘤(CAT)是一种罕见的非肿瘤性心脏肿块,最常见的部位是二尖瓣和二尖瓣环。二尖瓣瓣环钙化(MAC)的出现与中风或其他全身性栓塞的风险增加有关。在此,我们报告了一例伴有二尖瓣瓣环钙化(MAC)的二尖瓣瓣环钙化(CAT)病例,该病例显示二尖瓣瓣环钙化(MAC)快速生长,我们将研究两者之间的联系:一名 71 岁的男性因呼吸困难来我院就诊,他因慢性肾小球肾炎接受血液透析治疗已有 26 年。经胸超声心动图(TTE)显示二尖瓣中度狭窄,澳门巴黎人娱乐官网膨出。两个月后,患者出现进行性呼吸困难,随访 TTE 发现左心室(LV)侧后方澳门巴黎人娱乐官网附着一个高度移动的肿块(8 × 5 毫米)。由于充血性心力衰竭和栓塞的高风险,他接受了手术。手术检查发现,肿瘤附着在左心室侧二尖瓣 P3 节段下方,于是将其切除。切除澳门巴黎人娱乐官网时,牙膏样内容物从肿瘤所在的P3段澳门巴黎人娱乐官网内包裹的肿块中流出。用牛心包补片重建二尖瓣环后缺损后,进行了二尖瓣机械假体置换术、迷宫术和左阑尾闭合术。组织病理学检查显示,切除的肿瘤含有纤维蛋白和钙沉积物。该肿块被诊断为CAT:结论:CAT 可能是 MAC 诱发中风的原因之一。结论:CAT 可能是 MAC 诱发中风的原因之一,建议对 MAC 患者,尤其是接受血液透析的患者进行常规超声心动图随访。
Rapid growth of calcified amorphous tumor with mitral annulus calcification: a case report.
Background: Calcified amorphous tumor (CAT) of the heart is a rare, non-neoplastic cardiac mass with mitral valves and annuli being the most common sites. The presence of mitral annular calcification (MAC) is associated with an increased risk of stroke or other systemic embolisms. Here, we report a case of CAT showing rapid growth with MAC and investigate the link between the two.
Case presentation: A 71-year-old man presented at our hospital with dyspnea and had been undergoing hemodialysis for 26 years for chronic glomerulonephritis. Transthoracic echocardiography (TTE) revealed moderate mitral stenosis with bulky MAC. Two months later, the patient developed progressive dyspnea, and follow-up TTE revealed a highly mobile mass (8 × 5 mm) attached to the left ventricular (LV) side of the posterior MAC. He underwent surgery because of congestive heart failure and a high risk of embolization. Surgical inspection revealed that the tumor was attached beneath the P3 segment of the mitral valve on the LV side and was removed. When removing the MAC, toothpaste-like contents drained from the encapsulated mass inside the MAC at the P3 segment, where the tumor was located. After reconstructing the posterior mitral annulus defect with a bovine pericardial patch, mitral valve replacement with a mechanical prosthesis, a maze procedure, and left appendage closure were performed. Histopathological examination revealed that the excised tumor contained fibrin and calcium deposits. The mass was diagnosed as a CAT.
Conclusions: CAT may be one of the causes of stroke induced by MAC. Routine follow-up echocardiography should be recommended for patients with MAC, especially those undergoing hemodialysis.