4弁に発症した乳頭状線維弾性腫の1手術例  [in Japanese] Multiple Papillary Fibroelastomas Involving All Four Heart Valves  [in Japanese]

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Author(s)

    • 安藤 美月 Ando Mizuki
    • 琉球大学大学院胸部心臓血管外科 Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, University of the Ryukyus
    • 喜瀬 勇也 Kise Yuya
    • 琉球大学大学院胸部心臓血管外科 Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, University of the Ryukyus
    • 前田 達也 Maeda Tatsuya
    • 琉球大学大学院胸部心臓血管外科 Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, University of the Ryukyus
    • 稲福 斉 Inafuku Hitoshi
    • 琉球大学大学院胸部心臓血管外科 Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, University of the Ryukyus
    • 山城 聡 Yamashiro Satoshi
    • 琉球大学大学院胸部心臓血管外科 Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, University of the Ryukyus
    • 國吉 幸男 Kuniyoshi Yukio
    • 琉球大学大学院胸部心臓血管外科 Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, University of the Ryukyus

Abstract

<p>原発性心臓腫瘍は稀な疾患であり,その発症率は剖検例の0.0017~0.33%とされているが,心臓超音波検査の進歩および普及による診断学の発展に伴い,その診断率は年々上昇している.乳頭状線維弾性腫は粘液腫についで多い心臓原発性良性腫瘍で,多くは大動脈弁および僧帽弁に単発で生じることが多い無血管性乳頭腫であり,4弁すべてに発生した症例報告はない.今回われわれは意識消失を契機に発見された,若年女性の4弁すべてに発生した乳頭状線維弾性腫の1例を経験したので文献的考察を加え報告する.</p>

<p>Papillary fibroelastoma (PFE) is a rare primary cardiac tumor that usually involves an aortic or mitral heart valve. We encountered a case of a 32-year-old woman, who presented with syncope and was found to have multiple PFEs involving all four heart valves during surgery. The echocardiography was performed and showed two mobile masses near the tricuspid and mitral valves. Moreover, the enhanced computed tomography (CT) showed thickened aortic cusps, which may indicate the possibility of heart tumor. Intraoperatively, we first found multiple tumors at each cusp of the aortic valve, ranging in size from 5 to 10 mm which were excised without injury of aortic cusps themselves. These showed a sea anemone-like appearance and were suspected to represent PFE. We then observed the tricuspid and mitral valves, and both valves showed tumors of similar appearance in each cusp. Furthermore, we found a tumor at the pulmonary valve, even though there had been no evidence of its presence on echocardiography or CT. We confirmed that these masses were PFEs by histological study after the operation. We should keep in mind that PFE can develop in multiple valves. To the best of our knowledge, this is the first description of multiple PFEs involving all four heart valves.</p>

Journal

  • Japanese Journal of Cardiovascular Surgery

    Japanese Journal of Cardiovascular Surgery 48(4), 245-249, 2019

    The Japanese Society for Cardiovascular Surgery

Codes

  • NII Article ID (NAID)
    130007690570
  • Text Lang
    JPN
  • ISSN
    0285-1474
  • Data Source
    J-STAGE 
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