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原发性心脏肿瘤的临床病理特征和结局:中国医学中心 16 年 212 例患者的经验。

Clinicopathologic features and outcomes of primary cardiac tumors: a 16-year-experience with 212 patients at a Chinese medical center.

机构信息

Department of Pathology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China.

Department of General Surgery, People's Hospital of Longkou City, Shandong Province, China; Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China.

出版信息

Cardiovasc Pathol. 2018 Mar-Apr;33:45-54. doi: 10.1016/j.carpath.2018.01.003. Epub 2018 Jan 6.

Abstract

Primary cardiac tumors are uncommon, and the majority of them are benign which are curable but can cause significant morbidity if not diagnosed and treated in a timely fashion. The objective of this study was to review the clinicopathologic features and surgical outcomes of patients with primary cardiac tumors in a single medical center in China. We have retrospectively reviewed 212 consecutive adult patients who underwent surgical resection of primary cardiac tumors at our center from January of 2001 to June of 2017. All available clinicopathological features, imaging characteristics, and disease outcomes were summarized and presented. The present series enrolled 180 cardiac myxomas (84.9%) and 32 non-myxoma cases that included hemangioma, lipoma, papillary fibroelastoma, schwannoma, pericardial cyst, teratoma, paraganglioma, lymphoma, undifferentiated pleomorphic sarcoma, myxofibrosarcoma, angiosarcoma, and liposarcoma. All patients were diagnosed ante-mortem. The most frequent complaint was dyspnea. Benign tumors accounted for 93.9% of cases (199/212) and malignant tumors accounted for 5.7% (12/212), and the remaining one case was intermediate (paraganglioma). The outcome of benign tumors was favorable and only three recurrent cases were documented (1.5%) after surgical resection. All the seven patients with primary cardiac sarcomas (undifferentiated pleomorphic sarcoma, myxofibrosarcoma, angiosarcoma, and liposarcoma) suffered postoperative recurrence or disease related death. Cardiac myxoma represents the most frequent primary cardiac tumors. The clinical presentations, treatment strategies and outcomes of the primary cardiac tumors depend on the tumor location and histopathological type.

摘要

原发性心脏肿瘤并不常见,大多数为良性,可治愈,但如果不能及时诊断和治疗,会导致严重的发病率。本研究的目的是回顾单一医疗中心中国成人原发性心脏肿瘤患者的临床病理特征和手术结果。我们回顾性分析了 2001 年 1 月至 2017 年 6 月期间在我院接受手术切除的 212 例成人原发性心脏肿瘤患者。总结并呈现了所有可用的临床病理特征、影像学特征和疾病结局。本系列研究共纳入 180 例心脏黏液瘤(84.9%)和 32 例非黏液瘤病例,包括血管瘤、脂肪瘤、乳头状弹性纤维瘤、神经鞘瘤、心包囊肿、畸胎瘤、副神经节瘤、淋巴瘤、未分化多形性肉瘤、黏液纤维肉瘤、血管肉瘤和脂肪肉瘤。所有患者均为生前诊断。最常见的主诉是呼吸困难。良性肿瘤占 93.9%(199/212),恶性肿瘤占 5.7%(12/212),其余 1 例为中间型(副神经节瘤)。良性肿瘤的预后良好,仅 3 例术后复发(1.5%)。7 例原发性心脏肉瘤(未分化多形性肉瘤、黏液纤维肉瘤、血管肉瘤和脂肪肉瘤)患者均出现术后复发或与疾病相关的死亡。心脏黏液瘤是最常见的原发性心脏肿瘤。原发性心脏肿瘤的临床表现、治疗策略和结局取决于肿瘤位置和组织病理学类型。

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