Jodati Ahmadreza, Kazemi Babak, Safaei Naser, Toufan Mehrnoush
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
J Cardiovasc Thorac Res. 2013;5(2):77-80. doi: 10.5681/jcvtr.2013.017. Epub 2013 Jun 27.
Primary pericardial malignant mesothelioma is an extremely rare tumor even among all mesotheliomas with about 350 cases reported in the literature so far. Typically, it has an insidious presentation, with nonspecific signs and symptoms, and usually results in constrictive pericarditis, cardiac tamponade or congestive heart failure through either a massive effusion or direct tumurous constriction or invasion to the heart. With the exception of several case reports, the outcome is uniformly dismal and patients typically die within six months of diagnosis. We report a 24 year old male with long history of pleuretic chest paint and admissions with a diagnosis of idiopathic pericarditis, eventually presenting with increasing symptoms of heart failure and a large mobile ball like mass in the heart at echocardiographic and computed tomography studies. At operation, an atypical invasive cardiac tumor was discovered. Complete resection of the tumor was impossible and the patient died from progression of the disease 4 months later.
原发性心包恶性间皮瘤极为罕见,即便在所有间皮瘤中亦是如此,目前文献报道约有350例。通常,其表现隐匿,症状和体征不具特异性,常因大量积液、肿瘤直接压迫或侵犯心脏导致缩窄性心包炎、心脏压塞或充血性心力衰竭。除少数病例报告外,预后均很差,患者通常在诊断后六个月内死亡。我们报告一例24岁男性,有长期胸膜炎性胸痛病史,入院诊断为特发性心包炎,最终出现心力衰竭症状加重,超声心动图和计算机断层扫描显示心脏有一个巨大的可移动球状肿物。手术中发现一个非典型浸润性心脏肿瘤。肿瘤无法完全切除,患者在4个月后因疾病进展死亡。