title: Malignant fibrous histiocytoma of the heart complicated by factor XI deficiency in a Jehovah's Witness patient.
abstract: We describe a 16-year-old girl with malignant fibrous histiocytoma (MFH) of the heart complicated by factor XI deficiency. The preoperative diagnosis was left atrial myxoma. We decided to perform the operation owing to a normal bleeding time. Operative findings suggested a malignant tumor. The patient was a Jehovah's Witness, and extensive excision was not performed because blood transfusion was not allowed. We resected as much of the tumor and left atrial appendage as possible. The pathologic diagnosis was MFH. Excessive bleeding was not observed during the operation. Bleeding time helps to determine whether a surgical procedure is indicated in patients with factor XI deficiency.
authors.affiliation: Second Department of Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan. tuezu@med.u-ryukyu.ac.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Uezu
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kuniyoshi
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Miyagi
authors.forename: Katsuya
authors.initials: K
authors.lastname: Arakaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamashiro
authors.forename: Katsuhito
authors.initials: K
authors.lastname: Mabuni
authors.forename: Kageharu
authors.initials: K
authors.lastname: Koja
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000556:secondary; D020517:Atrial Appendage / Q000601:surgery*; D001760:Bleeding Time; D001780:Blood Coagulation Tests; D016063:Blood Loss, Surgical; D003951:Diagnostic Errors; D005173:Factor XI Deficiency / Q000150:complications* / Q000503:physiopathology; D017809:Fatal Outcome; D005260:Female; D006325:Heart Atria / Q000601:surgery*; D006338:Heart Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D018219:Histiocytoma, Benign Fibrous / Q000150:complications / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D006801:Humans; D033221:Jehovah's Witnesses; D009232:Myxoma / Q000175:diagnosis; D009364:Neoplasm Recurrence, Local; D011300:Preoperative Care; D011379:Prognosis; D016312:Treatment Refusal