Radulescu Dan, Pripon Sorin, Radulescu Letitia I, Constantea Nicolae A, Gulei Iulia
Department of Cardiology, 5th Medical Clinic, Municipal Hospital, University of Medicine andPharmacy Iuliu Hatieganu, Cluj-Napoca, Romania.
Rev Med Chil. 2008 Oct;136(10):1311-6. Epub 2009 Jan 15.
Primary malignant cardiac tumors are extremely rare, but their associated mortality is very high. The clinical presentation is oñen variable and nonspecific; by the time symptoms appear, the tumor has usually evolved to a large intracardiac and paracardiac mass causing considerable hemodynamic involvement, regional invasión and distant dissemination. We report a 26 year-old female with a right atrium angiosarcoma with a surprisingly favorable outcome at 2 years follow-up after treatment with a combination of neoadjuvant chemotherapy and surgical resection. She presented with chest tightness, shortness of breath at effort, atypical chest pain, palpitations, asthenia, weight loss and profuse perspiration. Physical examination and irnaging diagnostic procedures, identified a pericardial effusion and a pathologic cardiac mass. The diagnosis of a malignant angiosarcoma was suggested afier computed tomography transthoracic and transesophageal echocardiography It was confirmed at surgery by a biopsy followed by histopathology and immunohistochemistry.
原发性恶性心脏肿瘤极为罕见,但其相关死亡率却非常高。临床表现通常多变且无特异性;症状出现时,肿瘤通常已发展为巨大的心内和心旁肿块,导致相当程度的血流动力学受累、局部侵犯和远处转移。我们报告一例26岁女性右心房血管肉瘤患者,在接受新辅助化疗和手术切除联合治疗后,2年随访结果出人意料地良好。她表现为胸闷、活动时气短、非典型胸痛、心悸、乏力、体重减轻和大量出汗。体格检查和影像学诊断程序发现有心包积液和病理性心脏肿块。经胸部计算机断层扫描和经食管超声心动图检查后提示为恶性血管肉瘤,手术活检后经组织病理学和免疫组织化学确诊。