Karpuz Vildan, Ikitimur Bariş, Karpuz Hakan
Istanbul Bilim Universitesi Tip Fakültesi, Patoloji Anabilim Dali, Istanbul, Türkiye.
Anadolu Kardiyol Derg. 2007 Dec;7(4):427-35.
Heart tumors can be primary in origin, can develop from direct extension of a neighboring tumor or they can be the manifestation of metastasis of a distant tumor. Myxomas are the most frequently encountered primary benign cardiac tumors. Primary malignant tumors of the heart are rare, and they are mostly sarcomatous in structure. Secondary heart tumors constitute a wide spectrum, nevertheless they most frequently originate from lung cancer, breast cancer and hematological malignancies. Heart tumors may involve myocardium, endocardium, epicardium, pericardium, or any combination of the aforementioned layers. On the other hand, the usual site for metastasis to the heart is the pericardium. These tumors do not have a well- established classification. Clinical findings are usually non-specific and transient in nature and frequently present late in the disease process. Transthoracic and transesophageal echocardiography are the most widely used diagnostic modalities. Magnetic resonance imaging and computerized tomography may be helpful for selected cases. Surgery is the principal therapeutic option in benign tumors and when recurrences are not taken into account, they have favorable prognoses. Since surgical resection is usually incomplete in malignant tumors, therapy must be individualized for each patient; even with adjuvant chemotherapy, postoperative survival is usually short. Metastases to the heart are usually approached symptomatically except for exceptional cases.
心脏肿瘤可以是原发性的，可由邻近肿瘤直接蔓延发展而来，也可以是远处肿瘤转移的表现。黏液瘤是最常见的原发性心脏良性肿瘤。原发性心脏恶性肿瘤罕见，且大多为肉瘤结构。继发性心脏肿瘤种类繁多，但最常见的起源是肺癌、乳腺癌和血液系统恶性肿瘤。心脏肿瘤可累及心肌、心内膜、心包膜、心包，或上述各层的任意组合。另一方面，心脏转移瘤最常见的部位是心包。这些肿瘤尚无完善的分类。临床表现通常是非特异性的，且具有一过性，常在疾病晚期出现。经胸和经食管超声心动图是最广泛使用的诊断方法。磁共振成像和计算机断层扫描对部分病例可能有帮助。手术是良性肿瘤的主要治疗选择，不考虑复发情况时，预后良好。由于恶性肿瘤的手术切除通常不彻底，必须为每个患者制定个体化治疗方案；即使采用辅助化疗，术后生存期通常也较短。心脏转移瘤通常采取对症治疗，特殊情况除外。
