Hikosaka Yu, Yano Motoki, Otsuka Shinya, Sasaki Hidefumi, Moriyama Satoru, Okuda Katsuhiro, Shitara Masayuki, Fujii Yoshitaka
Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8602, Japan.
Gen Thorac Cardiovasc Surg. 2015 Jul;63(7):413-5. doi: 10.1007/s11748-013-0302-9. Epub 2013 Aug 3.
Whole pericardial irradiation may be performed for mediastinal malignancies with pericardial dissemination or malignant pericardial effusion. Case 1 is a 57-year-old woman with a B1 thymoma, Masaoka stage IVa. She underwent whole pericardial irradiation and suffered post-irradiation constrictive pericarditis 3 years later. Diuresis, catecholamine infusions, drainage, and pericardiectomy were performed. However, she died of heart failure after 4 years and 1 month due to constrictive pericarditis. Case 2 is a 56-year-old woman with myasthenia gravis and a B2 thymoma, Masaoka stage III. She underwent an extended thymectomy with partial resection of the lung and pericardium and received adjuvant radiation therapy of the whole pericardium. She was affected by post-irradiation constrictive pericarditis 7 months later, for which she underwent pericardiectomy. However, her constrictive pericarditis remained. In conclusion, we report two advanced thymoma cases with post-irradiation constrictive pericarditis. Indicators for whole pericardial irradiation should be determined strictly and carefully.
对于伴有心包播散或恶性心包积液的纵隔恶性肿瘤，可进行全心包照射。病例1是一名57岁女性，患有B1型胸腺瘤，Masaoka分期为IVa期。她接受了全心包照射，3年后出现放射性缩窄性心包炎。进行了利尿、儿茶酚胺输注、引流和心包切除术。然而，她在4年零1个月后因缩窄性心包炎死于心力衰竭。病例2是一名56岁女性，患有重症肌无力和B2型胸腺瘤，Masaoka分期为III期。她接受了扩大胸腺切除术，包括部分肺和心包切除，并接受了全心包辅助放疗。7个月后她出现放射性缩窄性心包炎，为此接受了心包切除术。然而，她的缩窄性心包炎仍然存在。总之，我们报告了两例晚期胸腺瘤合并放射性缩窄性心包炎的病例。全心包照射的指征应严格且谨慎地确定。
