Norita H, Ohteki H, Todaka K, Hisanou R, Yoshitake K, Yamada M
Department of Cardiovascular Surgery, Saga Prefectual Hospital Kouseikan, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Oct;40(10):1933-7.
A 59-year-old woman was referred to our hospital by a local cardiologist, with unknown cause of congestive heart failure and respiratory failure. No significant heart murmur was heard and a cardioechogram from the anterior chest was insufficient for diagnosis. On the night of admission, cardio-respiratory shock was found, and Swan-Gantz catheter data showed severe pulmonary hypertension. Transesophageal echo-cardiography (TEE) revealed a left atrial tumor, with wide neck anchored onto the posterior wall of the left atrium, and which was floating into the left ventricle during the diastolic phase. An emergency operation was performed and the tumor, (80 by 50 by 48 mm) was resected. The patient recovered well in the postoperation period. However the residual tumor continued to grow gradually in the pericardial cavity and the patient died 3 months after the operation. Primary MFH of the heart is rare and 29 cases have been reported. The prognosis of MFH is poor despite surgery. Whenever a left atrial tumor with a wide neck is attached to the posterior wall, it must be considered to be possibly malignant and surgical resection is recommended.
一名59岁女性由当地心脏病专家转诊至我院，患有病因不明的充血性心力衰竭和呼吸衰竭。未闻及明显心脏杂音，前胸心脏超声心动图检查结果不足以确诊。入院当晚，发现心源性呼吸休克，Swan-Gantz导管数据显示严重肺动脉高压。经食管超声心动图（TEE）显示左心房有一肿瘤，宽基底附着于左心房后壁，舒张期时肿瘤漂浮入左心室。遂进行急诊手术，切除肿瘤（80×50×48mm）。患者术后恢复良好。然而，残余肿瘤在心包腔内继续逐渐生长，患者术后3个月死亡。原发性心脏恶性纤维组织细胞瘤罕见，已报道29例。尽管进行了手术，恶性纤维组织细胞瘤的预后仍很差。每当发现宽基底的左心房肿瘤附着于后壁时，必须考虑其可能为恶性，建议手术切除。
