Edquist Mitchell, Lui Christopher, Kilimnik German, Karp Hillel
Newark Beth Israel Medical Center, Radiology Department, USA.
Newark Beth Israel Medical Center, Radiology Department, USA.
Clin Imaging. 2019 Mar-Apr;54:112-115. doi: 10.1016/j.clinimag.2018.12.004. Epub 2018 Dec 10.
We present a 36-year-old man who presented to our emergency department with acute onset shortness of breath and syncope. He was found to have a large left atrial mass on initial computed tomography (CT) which was confirmed by echocardiography. Tumor biopsy and attempted excision were performed, showing a primary cardiac spindle cell sarcoma that was unable to be resected, to which the patient eventually succumbed to. Spindle cell sarcomas of the heart are very rare primary cardiac tumors, with a variable, non-specific presentation. The most effective treatment is surgical resection, with chemotherapy and radiotherapy showing some benefit. Despite these treatments, the prognosis is poor. Given the uncommon nature of this tumor, the objective of this report is to demonstrate the clinical presentation and CT imaging characteristics of a case of primary cardiac spindle cell sarcoma, to raise awareness of this entity, and to increase the index of suspicion as a potential differential diagnosis to cardiac tumors seen on imaging.
我们报告一名36岁男性，他因急性发作的呼吸急促和晕厥前来我院急诊科就诊。初次计算机断层扫描（CT）发现他有一个巨大的左心房肿块，超声心动图证实了这一发现。进行了肿瘤活检和切除尝试，结果显示为原发性心脏梭形细胞肉瘤，无法切除，患者最终因此死亡。心脏梭形细胞肉瘤是非常罕见的原发性心脏肿瘤，表现多样且不具有特异性。最有效的治疗方法是手术切除，化疗和放疗也显示出一定益处。尽管采取了这些治疗措施，预后仍然很差。鉴于这种肿瘤的罕见性，本报告的目的是展示一例原发性心脏梭形细胞肉瘤的临床表现和CT影像特征，提高对该疾病的认识，并增加对影像学上所见心脏肿瘤作为潜在鉴别诊断的怀疑指数。
