Vargas-Barron J, Keirns C, Barragan-Garcia R, Beltran-Ortega A, Rotberg T, Santana-Gonzalez A, Salazar-Davila E
Department of Echocardiography, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico.
J Thorac Cardiovasc Surg. 1990 Jun;99(6):1099-103.
The echocardiographic findings of two unusual cases of malignant uterine tumors that invaded the heart are reported. A woman previously operated on for invasive cervical carcinoma had multiple embolic phenomena and evidence of obstruction to mitral flow. An echocardiogram showed a mass in the left atrium that reached the mitral valve ring. The tumor was implanted in a pulmonary vein and was removed with no complications. Cell type indicated metastatic carcinoma of the cervix. In the second case the patient had a large abdominal mass and precordial manifestations of obstruction and regurgitation of the tricuspid valve. An echocardiogram showed that a mass emanating from the inferior vena cava filled the right atrium and part of the right ventricle. The trajectory of the tumor was followed to its origin in an ovarian vein by tomography. The entire tumor was removed and identified as endometrial stromal sarcoma. An increase in operations with or without radiation therapy for malignant tumors has augmented the frequency of metastatic invasion of the heart; intracavitary extension tends to results from embolization or propagation along great veins. This is the first report of a uterine carcinoma reaching the heart by way of the pulmonary veins and of invasion of the heart by endometrial stromal sarcoma, both with successful excision.
本文报告了两例罕见的恶性子宫肿瘤侵犯心脏的超声心动图检查结果。一名曾因浸润性宫颈癌接受手术的女性出现了多次栓塞现象以及二尖瓣血流受阻的证据。超声心动图显示左心房有一肿块，延伸至二尖瓣环。肿瘤种植于肺静脉，手术切除后无并发症。细胞类型显示为宫颈转移性癌。第二例患者有巨大腹部肿块，并有三尖瓣梗阻和反流的心前区表现。超声心动图显示下腔静脉有一肿块充满右心房及部分右心室。通过断层扫描追踪肿瘤轨迹至其起源于卵巢静脉。整个肿瘤被切除，病理诊断为子宫内膜间质肉瘤。恶性肿瘤无论是否接受放疗，手术量的增加都导致了心脏转移侵犯频率的上升；腔内扩展往往是由栓塞或沿大静脉蔓延所致。本文首次报道了子宫癌经肺静脉侵犯心脏以及子宫内膜间质肉瘤侵犯心脏，两例均成功切除。
