Department of Cardiothoracic Surgery, Division of Cardiac Surgery, University Hospital of Münster.
Dtsch Arztebl Int. 2014 Mar 21;111(12):205-11. doi: 10.3238/arztebl.2014.0205.
Primary tumors of the heart are rare even in major cardiac surgery centers. Because of the low case numbers, there is an insufficient evidence base to determine the optimal treatment, particularly for malignant tumors.
The authors review the pertinent literature retrieved by a selective PubMed search on the terms "cardiac tumor," "heart tumor," "cardiac myxoma," and "cardiac sarcoma." They also present operative techniques and their own long-term results in 181 patients with cardiac tumors.
Patients with cardiac tumors generally have nonspecific symptoms depending on the site of the tumor and the extent of infiltration into the neighboring tissue. The diagnosis is based on the clinical history, echocardiography (in most cases), and, sometimes, computerized tomography and magnetic resonance imaging. Autopsy studies reveal a 0.02% prevalence of cardiac tumors, of which 75% are benign and 25% malignant. Myxoma is the most common benign tumor (50-70%); angiosarcoma is the most common malignant one (30%), followed by rhabdomyosarcoma (20%). About 10% of all tumor patients develop cardiac metastases, but these are only rarely clinically manifest. From 1989 to 2012, 181 patients underwent surgery for cardiac tumors in the authors' institution. The 5-year survival rates were 83% for benign tumors (139 patients), 30% for malignant tumors (26 patients), and 26% for cardiac metastases (16 patients).
Patients with cardiac tumors should undergo surgery in a timely fashion in a specialized center. This holds for both malignant and benign tumors, particularly for atrial myxoma, which can cause serious secondary complications by embolization.
即使在大型心脏手术中心，心脏原发性肿瘤也很少见。由于病例数量较少，缺乏确定最佳治疗方法的充分证据，尤其是恶性肿瘤。
作者通过选择性 PubMed 搜索，检索了“心脏肿瘤”、“心脏肿瘤”、“心脏粘液瘤”和“心脏肉瘤”等术语的相关文献，并回顾了 181 例心脏肿瘤患者的手术技术及其长期结果。
心脏肿瘤患者通常根据肿瘤部位和邻近组织浸润程度出现非特异性症状。诊断基于临床病史、超声心动图（大多数情况下），有时还需要计算机断层扫描和磁共振成像。尸检研究显示，心脏肿瘤的患病率为 0.02%，其中 75%为良性，25%为恶性。粘液瘤是最常见的良性肿瘤（50-70%）；血管肉瘤是最常见的恶性肿瘤（30%），其次是横纹肌肉瘤（20%）。约 10%的肿瘤患者发生心脏转移，但这些转移很少有临床表现。1989 年至 2012 年，作者所在机构对 181 例心脏肿瘤患者进行了手术。良性肿瘤（139 例）的 5 年生存率为 83%，恶性肿瘤（26 例）为 30%，心脏转移（16 例）为 26%。
心脏肿瘤患者应及时在专门中心进行手术。这适用于良性和恶性肿瘤，特别是心房粘液瘤，它可通过栓塞引起严重的继发性并发症。
