Garg Naveen, Moorthy Nagaraja, Agrawal Surendra K, Pandey Santanu, Kumari Niraj
Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India.
Tex Heart Inst J. 2011;38(4):441-4.
Malignant metastases to the heart and pericardium, which occur far more often than do primary cardiac neoplasms, typically lead to fatal outcomes. The phyllodes tumor is a rare, predominantly benign fibroepithelial breast neoplasm with variable malignancy potential. Herein, we describe the case of a 35-year-old woman who, 3 years after undergoing a simple mastectomy for a rapidly enlarging breast neoplasm, presented with cardiogenic shock and was found to have a large right ventricular tumor that obstructed the right ventricular outflow tract. Despite successful resection of the ventricular mass and a right atrial mass of organized thrombus, the patient died 8 days postoperatively of multiorgan failure due to severe right ventricular dysfunction. Histopathologic analysis determined that the right ventricular mass was a malignant, metastatic phyllodes tumor. To our knowledge, this is only the 2nd reported case of a phyllodes tumor that metastasized to the heart and presented as an intracavitary mass with cardiogenic shock. In addition to discussing our patient's case, we review the pertinent medical literature.
恶性肿瘤转移至心脏和心包远比原发性心脏肿瘤常见，通常会导致致命后果。叶状肿瘤是一种罕见的、以良性为主的纤维上皮性乳腺肿瘤，具有不同程度的恶性潜能。在此，我们描述了一名35岁女性的病例，她在因快速增大的乳腺肿瘤接受单纯乳房切除术后3年，出现心源性休克，发现有一个大的右心室肿瘤阻塞了右心室流出道。尽管成功切除了心室肿物和右心房内的机化血栓肿物，但患者术后8天因严重右心室功能障碍死于多器官功能衰竭。组织病理学分析确定右心室肿物是恶性转移性叶状肿瘤。据我们所知，这是第二例报道的叶状肿瘤转移至心脏并表现为心腔内肿物伴心源性休克的病例。除了讨论我们患者的病例外，我们还回顾了相关医学文献。
