Department of Cardiac Surgery, S Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Eur J Cardiothorac Surg. 2012 Apr;41(4):812-9. doi: 10.1093/ejcts/ezr067. Epub 2011 Dec 7.
Primary heart tumours are rare lesions with variegated histological types. We reviewed our 35 years experience with a significant number of primary benign cardiac tumour cases.
The patient database at University of Bologna was searched to identify patients with primary cardiac tumours between 1974 and 2009. Benign tumours were classified as myxomas and non-myxomas. Ninety-four were myxomas (mean age of 59.1 ± 15.6), and 13 were benign non-myxomas tumours (mean age of 39.7 ± 24.9; P = 0.0001). Complete resection of the masses was performed in all cases except in one.
In-hospital mortality was 3% in the myxoma group and 8% in the non-myxoma group. The mean follow-up was 15.1 and 7.4 years for the myxoma and non-myxoma groups, respectively. The long-term survival of discharged patients was 68 ± 7% for the myxoma group and 100% for the non-myxoma group at 20 years, respectively. Recurrence of a tumour occurred only in the myxoma group (four cases) after 1, 3, 5 and 8 years, respectively. Twenty patients had an extracardiac tumour that was diagnosed before operation in 12 (11 in the myxoma group) and during the follow-up in 8 patients (only in the myxoma group).
Primary cardiac tumours can be surgically treated with good short- and long-term results. Mortality and morbidity are mainly due to the status of preoperative patients'. An accurate follow-up is mandatory in order to detect the recurrence of a cardiac tumour such as to exclude the presence or the development of extracardiac tumours that we found frequently associated with the myxoma.
原发性心脏肿瘤是一种罕见的病变,具有多种组织学类型。我们回顾了 35 年来大量原发性良性心脏肿瘤病例的经验。
在博洛尼亚大学的患者数据库中搜索 1974 年至 2009 年间患有原发性心脏肿瘤的患者。良性肿瘤分为黏液瘤和非黏液瘤。94 例为黏液瘤(平均年龄 59.1±15.6),13 例为良性非黏液瘤肿瘤(平均年龄 39.7±24.9;P=0.0001)。除 1 例外,所有病例均行肿块完全切除术。
黏液瘤组住院死亡率为 3%,非黏液瘤组为 8%。黏液瘤组和非黏液瘤组的平均随访时间分别为 15.1 年和 7.4 年。黏液瘤组出院患者的长期生存率为 68±7%,而非黏液瘤组在 20 年时为 100%。肿瘤复发仅发生在黏液瘤组(4 例),分别在 1、3、5 和 8 年后。20 例患者有心脏外肿瘤,其中 12 例(黏液瘤组 11 例)在术前诊断,8 例(仅在黏液瘤组)在随访期间诊断。
原发性心脏肿瘤可以通过手术治疗获得良好的短期和长期效果。死亡率和发病率主要取决于患者术前的状态。必须进行准确的随访,以检测心脏肿瘤的复发,以排除我们经常发现的与黏液瘤相关的心脏外肿瘤的存在或发展。