May Matthias, Finkbeiner Yorck, Gunia Sven, Seehafer Matthias, Knörig Joachim, Hetzer Roland
Urology Clinic, Carl-Thiem Hospital, Cottbus, Berlin-Charité University Teaching Hospital, Cottbus, Germany.
Heart Vessels. 2006 Jan;21(1):63-5. doi: 10.1007/s00380-005-0829-5.
Cardiac intracavitary metastases are very uncommon. The case of a 42-year-old male patient with a testicular germ cell tumor extending into the superior caval vein, the left brachiocephalic vein, and the right heart, which manifested as a mild form of pulmonary embolization, is presented. Due to the perceived high risk of continuous embolization and the urgent need to begin systemic chemotherapy, a complete cardiac tumor resection was performed, utilizing a cardiopulmonary bypass, followed by a simultaneous orchiectomy. Histology revealed a 61-cm long vascular tumor as a metastasis of a yolk sac tumor originating from the left testis. There were no postoperative complications, and the patient is alive and without tumor recurrence 12 months after four cycles of systemic chemotherapy according to the PEB (cisplatin, etoposide, bleomycin) scheme. We conclude that in this special case aggressive surgical management following chemotherapy was very effective in controlling the disseminated testicular tumor.
心脏腔内转移非常罕见。本文报告了一例42岁男性患者，其睾丸生殖细胞肿瘤延伸至上腔静脉、左头臂静脉和右心，表现为轻度肺栓塞形式。由于认为持续栓塞风险高且急需开始全身化疗，遂在体外循环辅助下进行了完整的心脏肿瘤切除术，随后同时进行了睾丸切除术。组织学检查显示一个61厘米长的血管性肿瘤，为起源于左侧睾丸的卵黄囊瘤转移灶。术后无并发症，根据PEB（顺铂、依托泊苷、博来霉素）方案进行四个周期的全身化疗后12个月，患者存活且无肿瘤复发。我们得出结论，在这种特殊情况下，化疗后积极的手术治疗对控制播散性睾丸肿瘤非常有效。
