Brown B C, Mason T E, Ballard W P, Wickliffe C W, Bone D
Pathology Department, Piedmont Hospital, Atlanta, GA 30309.
J Med Assoc Ga. 1991 Aug;80(8):435-8.
Primary neoplasms of the heart are rare and difficult to diagnose prior to surgery, even with modern imaging techniques. Often, the tumors are diagnosed only at autopsy. Angiosarcoma is the most common malignant neoplasm. This disease is most commonly found in middle-aged men, and the tumor is most often located in the right atrium. It commonly causes blood flow abnormalities, extensively infiltrates cardiac structures, and may extend through the heart wall to involve adjacent structures. Metastatic spread at the time of diagnosis is common, and surgical mortality is high. We present a case of primary angiosarcoma involving the right ventricle of the heart. This tumor developed 6 months after the patient had undergone coronary artery bypass surgery. The patient was initially thought to have a massive thrombus within the right ventricle but at surgery was found to have a malignant neoplasm invading the myocardium. Subsequently, he was found to have pulmonary metastases. A debulking procedure was performed, and the patient was started on chemotherapy. Rather prompt improvement occurred after the debulking procedure, but subsequent studies have indicated progression of the pulmonary metastases despite ongoing chemotherapy.
原发性心脏肿瘤很罕见，即使采用现代成像技术，在手术前也难以诊断。通常，这些肿瘤仅在尸检时才被发现。血管肉瘤是最常见的恶性肿瘤。这种疾病最常见于中年男性，肿瘤最常位于右心房。它通常会导致血流异常，广泛浸润心脏结构，并可能穿透心脏壁累及相邻结构。诊断时发生转移很常见，手术死亡率很高。我们报告一例累及右心室的原发性血管肉瘤病例。该肿瘤在患者接受冠状动脉搭桥手术后6个月出现。患者最初被认为右心室内有巨大血栓，但手术时发现是恶性肿瘤侵犯心肌。随后，发现他有肺转移。进行了减瘤手术，并开始对患者进行化疗。减瘤手术后病情迅速改善，但后续研究表明，尽管持续化疗，肺转移仍有进展。
