Haponiuk Ireneusz, Chojnicki Maciej, Jaworski Radoslaw, Zielinski Jacek, Irga-Jaworska Ninela, Gierat-Haponiuk Katarzyna, Sroka Mariusz
Department of Pediatric Cardiac Surgery, Mikołaj Kopernik Pomeranian Centre of Traumatology, Gdansk, Poland.
Contemp Oncol (Pozn). 2013;17(2):225-7. doi: 10.5114/wo.2013.34630. Epub 2013 Apr 29.
We present the dramatic course of a female 5-year-old child with pneumonia and symptoms similar to local compression of the pericardium by a tumorous mass originating from the left lung. The child was treated with antibiotics for pneumonia with bilateral pleural effusions that required chest drainage. On the 10(th) day of therapy there was sudden anemia observed with the echocardiographic finding of acute cardiac tamponade. The child was referred for emergency life-saving surgical intervention. The chest was opened via a minimally invasive mini-incision in the area of the xiphoid process and bloody tension pericardial effusion was evacuated. The laboratory and histopathology investigations were not specific for neoplastic disease or tuberculosis infection. In the further observation the girl recovered and was discharged home two weeks after tamponade drainage. Fortunately our initial suspicion of neoplastic disease was not proved; nevertheless we would like to emphasize the need for oncologic vigilance in similar cases.
我们报告了一名5岁女童的戏剧性病程,她患有肺炎,症状类似于左肺肿瘤性肿块对心包的局部压迫。该患儿因双侧胸腔积液的肺炎接受抗生素治疗,胸腔积液需要胸腔引流。在治疗的第10天,突然出现贫血,超声心动图检查发现急性心脏压塞。患儿被转诊进行紧急救生手术干预。通过剑突下区域的微创小切口打开胸腔,排出了血性张力性心包积液。实验室和组织病理学检查对肿瘤性疾病或结核感染均无特异性。在进一步观察中,女孩康复,心包积液引流两周后出院回家。幸运的是,我们最初对肿瘤性疾病的怀疑未得到证实;尽管如此,我们仍想强调在类似病例中保持肿瘤学警惕的必要性。