점액종에 의한 우심실 유출로 협착

Right Ventricular Myxoma Obstructing Right Ventricular Outflow Tract

  • 송광재 (울산대학교 의과대학 서울아산병원 소아심장외과) ;
  • 윤태진 (울산대학교 의과대학 서울아산병원 소아심장외과)
  • Song Kwang-Jae (Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yun Tae-Jin (Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 발행 : 2006.08.01

초록

심장 내 점액종은 심장에 발생하는 원발성 종양 중 가장 흔하지만, 우심실 유출로 협착을 유발하는 점액종은 비교적 드물다. 15세 여자 환자가 운동 시 호흡 곤란 및 간헐적인 의식 소실을 주소로 내원하였고, 심초음파상 우심실 유출로를 거의 폐쇄하는 $3.6{\times}3.0\;cm$ 크기의 종괴가 발견되어 응급수술이 시행되었다. 우심실 종괴가 폐동맥 직하 부위의 우심실 전벽으로부터 기시하고 있음을 확인하고, 종괴 기시 부위 주위의 우심실 전벽을 광범위하게 절제하면서 종괴를 제거하였고 우심실 전벽의 결손은 Gore-Tex 포편 봉합하였다. 병리학적 검사상 우심실에 발생한 점액종으로 진단되었으며, 환자는 특별한 문제없이 술 후 7일째 퇴원하였다.

Cardiac myxoma is the most common primary tumor of the heart, but right ventricular myxoma causing outflow obstruction is relatively rare. A 15 years old girl developed dyspnea on exertion and intermittent syncope caused by a right ventricular mass obstructing the right ventricle outflow tract. Transthoracic echocardiography revealed $3.6{\times}3.0\;cm$ sized pedunculated subpumonic mass originating from the right ventricular anterior free wall. The patient underwent an emergency operation, consisting of the removal of the mass by wide excision of the tumor base and PTFE (polytetrafluoroethylene) patching of the right ventricular anterior free wall defect. Pathological findings of the mass were compatible with myxoma, and the patient was discharged uneventfully 7 days after the operation.

키워드

참고문헌

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