Hasegawa Tasuku, Nakagawa Susumu, Chino Masao, Kunihiro Takamu, Ui Susumu, Kimura Mitsuru
Department of Cardiology, Tokyo Saiseikai Central Hospital, Mita 1-4-17, Minato-ku, Tokyo 108-0073.
J Cardiol. 2002 Jun;39(6):321-5.
A 53-year-old woman presented with a primary cardiac sarcoma mimicking benign myxoma manifesting as progressive heart failure. Transesophageal echocardiography disclosed two separate tumors in the left atrium which appeared just like myxoma, except for the origin and multiple growth profile. Three separate tumors were identified during the operation arising from the posterior wall of the left atrium, mitral valve orifice and left atrial free wall. The histological diagnosis was malignant undifferentiated sarcoma. Six months later, she noticed dyspnea and arm numbness due to local recurrence of cardiac tumor and brain metastasis. She died suddenly 6 months after the surgery during admission. The clinical and echocardiographic findings are crucial to discriminate malignant cardiac tumors from benign myxoma. Rapidly progressive clinical course, multiple tumor growth and non-septal attachment of the tumor all suggest a malignant profile of the primary cardiac tumors. Careful and precise preoperative evaluation, including echocardiographic survey of the tumor origin and multiple growth profile, are essential to identify malignant cardiac tumor.
一名53岁女性因原发性心脏肉瘤表现为进行性心力衰竭，酷似良性黏液瘤。经食管超声心动图显示左心房有两个独立的肿瘤，除起源和多灶生长特征外，外观酷似黏液瘤。手术中发现三个独立的肿瘤，分别起源于左心房后壁、二尖瓣口和左心房游离壁。组织学诊断为恶性未分化肉瘤。六个月后，她因心脏肿瘤局部复发和脑转移出现呼吸困难和手臂麻木。术后6个月住院期间突然死亡。临床和超声心动图表现对于鉴别恶性心脏肿瘤和良性黏液瘤至关重要。快速进展的临床病程、多灶肿瘤生长以及肿瘤非间隔附着均提示原发性心脏肿瘤的恶性特征。仔细精确的术前评估，包括对肿瘤起源和多灶生长特征的超声心动图检查，对于识别恶性心脏肿瘤至关重要。
