PDF(Pubmed)
Abstract：
A 49-year-old female patient, asymptomatic, presented to the cardiology office for a right atrial mass, identified incidentally in a non-electrocardiogram (ECG)-gated contrast-enhanced computed tomography, performed for follow-up of pulmonary tuberculosis. Echocardiography, surprisingly, showed an anechogenic ovoid mass in the right atrium measuring 40 × 40 mm2, implanted in the interatrial septum without affecting the tricuspid valve. ECG-gated computed tomography angiography (CTA), confirmed the dimensions of the mass, which presented homogeneous content, calcified areas, and a 12-mm pedicle implanted near the ostium of the coronary sinus. Additionally, contrast uptake and infiltration of adjacent structures were ruled out. In the surgical field, an encapsulated mass with blood content was found, which pathology reported as a hematic endocardial cyst (HEC). These are rare cardiac masses, constituting 1.5% of all primary cardiac tumors. It is usually an incidental finding, and its clinical presentation will depend on its dimensions and the intracardiac hemodynamic impact. A highlighting feature is its anechogenic content on ultrasound, however, multimodality imaging allows for making diagnostic assumptions, discerning between primary cardiac tumors, and provides morphological and hemodynamic information useful for therapeutic decision making. The age of the patient, the large size of the HEC, and its location in the interatrial septum make up a completely atypical presentation of this rare disease, which motivated this report.
摘要：
一名49岁的女性患者,无症状，被送到心脏病学办公室治疗右心房肿块，在非心电图（ECG）门控对比增强计算机断层扫描中偶然发现，进行肺结核的随访。超声心动图,令人惊讶的是,显示右心房有40×40mm2的消声卵形肿块，植入房间隔而不影响三尖瓣。心电门控计算机断层扫描血管造影(CTA),确认了质量的大小，呈现均匀的内容，钙化区域,在冠状窦口附近植入一个12毫米的椎弓根。此外,排除了造影剂的吸收和相邻结构的浸润。在外科领域，发现了一个含有血液含量的包裹块，病理报告为血源性心内膜囊肿（HEC）。这些是罕见的心脏肿块，占所有原发性心脏肿瘤的1.5%。这通常是偶然发现，其临床表现将取决于其尺寸和心内血流动力学影响。一个突出的特征是它在超声波上的消声内容，然而,多模态成像允许做出诊断假设，辨别原发性心脏肿瘤，并提供对治疗决策有用的形态学和血液动力学信息。病人的年龄,HEC的大尺寸，它在房间隔中的位置构成了这种罕见疾病的完全非典型表现，这激发了这份报告。
