右房海綿状血管腫の1例

Cardiac Cavernous Hemangioma in the Right Atrium：Report of a Case

はじめに　心臓血管腫は原発性心臓腫瘍の2.8～4.4％を占めるきわめてまれな疾患であり1），海綿状型，毛細血管型，動静脈型に分類されるが，海綿状型は心臓血管腫のうち50～60％を占めると報告されている2～4）．心臓血管腫は，塞栓症，不整脈，腫瘍破裂といった致死的な合併症をきたすことがあり，一般的に手術による腫瘍摘出が推奨される2，4，5）．われわれは乳癌経過観察中の造影CTで偶発的に発見された右房海綿状血管腫の1手術例を経験したので報告する．

Cardiac hemangioma is a rare benign tumor, and the cavernous type accounts for 50～60％ of all cardiac hemangiomas. Although most cases are asymptomatic, the risk of serious complications, such as embolism, arrhythmia, tumor rupture, coronary artery obstruction, or sudden death, is high, and surgical resection should be considered. In a 60-year-old woman, follow-up imaging studies after a left breast cancer operation incidentally revealed a cardiac tumor in the right atrium. Transthoracic echocardiography showed a poorly mobile, highly echogenic 12×16 mm mass with clear margins, and contrast-enhanced computed tomography （CT） showed a round tumor with no obvious enhancement. The tumor was resected with an atrial wall and diagnosed as a cavernous hemangioma on histopathological examination. Cardiac hemangiomas are enhanced using contrast medium；however, some cases have no contrast enhancement. Histopathological examination confirmed this diagnosis. The patient was discharged on postoperative day 11 in a good condition.