Lin Yu-Sheng, Jung Shih-Ming, Tsai Feng-Chun, Yeh Chun-Nan, Shiu Tzu-Fang, Wu Hsueh-Hua, Lin Pyng-Jing, Chu Pao-Hsien
The First Cardiovascular Division, Department of Internal Medicine, Chang Gung Memorial Hospital, 199 Tun-Hwa North Road, Taipei 105, Taiwan, China.
World J Gastroenterol. 2007 Jul 7;13(25):3513-6. doi: 10.3748/wjg.v13.i25.3513.
To investigate the clinical and pathologic findings, and to discuss the pathophysiology of hepatocellular carcinoma with cardiac metastasis.
Eight hepatoma patients with cardiac metastasis, who were treated by surgical excision from 1993 to 2006, were retrospectively studied. Detailed clinical parameters were analyzed.
Of those eight patients, two (25%) were women and six (75%) were men, with the mean age of 50 years (range, 40-70 years). The presentations included: asymptomatic (75%), heart failure (25%), and pulmonary embolism (12.5%). All lesions involved the right atrium, and extended to the lung (12.5%), inferior vena cava (25%), and left atrium (12.5%). The level of tumor marker, alpha-fetal protein, was not correlated with the severity of metastasis or disease prognosis. Moreover, the availably estimated doubling time was less than 3 mo. The pathological findings included variable hemorrhage and necrosis. The survival time following surgery also varied from one month to more than 30 mo.
Hepatoma metastasis to the heart was detected in all eight patients. This study demonstrates that surgery might help the outcome in such cases.
探讨肝细胞癌心脏转移的临床及病理表现，并讨论其病理生理学机制。
回顾性研究1993年至2006年期间接受手术切除治疗的8例发生心脏转移的肝癌患者。分析详细的临床参数。
8例患者中，女性2例（25%），男性6例（75%），平均年龄50岁（范围40 - 70岁）。临床表现包括：无症状（75%）、心力衰竭（25%）和肺栓塞（12.5%）。所有病灶均累及右心房，并扩展至肺（12.5%）、下腔静脉（25%）和左心房（12.5%）。肿瘤标志物甲胎蛋白水平与转移严重程度或疾病预后无关。此外，可获得的估计倍增时间小于3个月。病理表现包括不同程度的出血和坏死。术后生存时间从1个月到超过30个月不等。
8例患者均检测到肝癌转移至心脏。本研究表明，手术可能有助于改善此类病例的预后。
