Dedeilias Panagiotis, Nenekidis Ioannis, Koukis Ioannis, Anagnostakou Vania, Paparizou Niki, Zompolos Spyros, Apostolakis Efstratios
1st Department of Cardiac Surgery, Evangelismos General Hospital, Athens, Greece.
J Cardiothorac Surg. 2011 Aug 26;6:102. doi: 10.1186/1749-8090-6-102.
We present a symptomatic 40-year-old cirrhotic man who presented with sudden onsets of syncope. Echocardiography revealed right ventricular outflow track obstruction caused by a huge right atrial mass. The tumor was surgically excised under cardiopulmonary bypass. Although no primary cancerous lesion in the liver was detected, histopathology revealed that the mass was a metastatic hepatocellular carcinoma. The aim of this report is to show the value of urgent preoperative computed tomography and its contribution in the operative strategy. The importance of urgent surgical treatment with tricuspid valve sparing tumor resection is emphasized even though the prognosis for such patients is dismal. We also discuss the further management options of such rare cases.
我们报告一名40岁有症状的肝硬化男性，他突然出现晕厥。超声心动图显示巨大右心房肿块导致右心室流出道梗阻。在体外循环下手术切除了肿瘤。尽管未在肝脏中检测到原发性癌灶，但组织病理学显示该肿块为转移性肝细胞癌。本报告的目的是展示术前紧急计算机断层扫描的价值及其在手术策略中的作用。强调了即使此类患者预后不佳，保留三尖瓣的肿瘤切除术进行紧急手术治疗的重要性。我们还讨论了此类罕见病例的进一步管理选择。
