Yokoyama Yoshihito, Ono Yuichi, Sakamoto Tomomi, Fukuda Ikuo, Mizunuma Hideki
Department of Obstetrics and Gynecology, Hirosaki University School of Medicine, 5-Zaifu-cho, Hirosaki 036-8562, Japan.
Gynecol Oncol. 2004 Mar;92(3):999-1001. doi: 10.1016/j.ygyno.2003.11.049.
The endometrial stromal sarcoma (ESS) is a rare neoplasm of the uterine origin. Intracardiac metastasis from the low-grade ESS is an extremely rare event. A case of a patient who successfully underwent surgical extraction of metastatic tumors of the low-grade ESS in the right ventricle is described in the present report.
A 48-year-old woman was considered recurrence of the low-grade ESS 4 years after the initial operation for this disease. The CT scanning and magnetic resonance imaging demonstrated solid masses in the pelvis, the lungs, the inferior vena cava, and the right ventricle. The chemotherapy was effective against the recurrent tumors except for intracardiac site. Although she had no symptoms of right-sided heart failure, surgical resection of the intracardiac masses was successfully performed. Pathological examination confirmed intracardiac recurrent low-grade ESS.
Surgical approach to intracardiac metastasis of the low-grade ESS is considered viable because of an excellent long-term prognosis in this disease and the likelihood of fatal heart failure or sudden death in untreated cases.
子宫内膜间质肉瘤(ESS)是一种罕见的子宫源性肿瘤。低级别ESS发生心脏内转移极为罕见。本报告描述了一例成功手术切除右心室低级别ESS转移瘤的患者。
一名48岁女性在初次手术后4年被认为是低级别ESS复发。CT扫描和磁共振成像显示盆腔、肺部、下腔静脉及右心室内有实性肿块。化疗对除心脏内病灶外的复发性肿瘤有效。尽管她没有右侧心力衰竭的症状,但仍成功进行了心脏内肿块的手术切除。病理检查证实为心脏内复发性低级别ESS。
考虑到低级别ESS心脏内转移的长期预后良好,且未经治疗的病例有发生致命性心力衰竭或猝死的可能,手术治疗该疾病是可行的。