在体外循环和循环停止下切除延伸至右心房的下腔静脉巨大原发性滑膜肉瘤并进行腔静脉重建。
Resection of a giant primary synovial sarcoma of the inferior vena cava extending into the right atrium with caval reconstruction under cardiopulmonary bypass and circulatory arrest.
作者信息
Wise Kevin B, Said Sameh M, Clark Clancy J, Okuno Scott H, Shah Sejal S, Park Soon J, Nagorney David M, Gloviczki Peter
机构信息
Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
出版信息
Perspect Vasc Surg Endovasc Ther. 2012 Jun;24(2):95-101. doi: 10.1177/1531003512468035.
BACKGROUND
Synovial sarcoma primarily arises in para-articular locations of the extremities. However, numerous unique sites of origin have been reported. There are only 5 known cases of primary intravascular synovial sarcoma.
METHODS
We present the second reported case of synovial sarcoma arising from the inferior vena cava (IVC) in a 41-year-old woman with progressive fatigue, abdominal distension, and lower-extremity swelling. This is the first known case with a monophasic histological subtype.
RESULTS
The tumor arose from the retrohepatic IVC with cephalad extension into the right atrium. Excision required cardiopulmonary bypass and deep hypothermic circulatory arrest, followed by bovine pericardial patch reconstruction of the IVC.
CONCLUSIONS
Primary synovial sarcoma of the IVC is rare. The use of cardiopulmonary bypass with or without deep hypothermic circulatory arrest may be required if there is tumor extension into the heart. Bovine pericardium is an excellent material for caval reconstruction.
背景
滑膜肉瘤主要起源于四肢关节旁部位。然而，已有许多独特的起源部位被报道。原发性血管内滑膜肉瘤仅有5例已知病例。
方法
我们报告了第二例起源于下腔静脉（IVC）的滑膜肉瘤病例，患者为一名41岁女性，有进行性疲劳、腹胀和下肢肿胀症状。这是已知的首例单相组织学亚型病例。
结果
肿瘤起源于肝后下腔静脉，向上延伸至右心房。切除肿瘤需要体外循环和深低温停循环，随后用牛心包补片重建下腔静脉。
结论
下腔静脉原发性滑膜肉瘤罕见。如果肿瘤延伸至心脏，可能需要使用体外循环，可伴有或不伴有深低温停循环。牛心包是用于腔静脉重建的优质材料。
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