Sia Ching-Hui, Goh Fang Qin, Kong William Kok-Fai, Wu Bingcheng, Paranjothy Suresh
Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore.
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
J Card Surg. 2020 May;35(5):1148-1151. doi: 10.1111/jocs.14541. Epub 2020 Apr 15.
Cardiac sarcoma is a rare condition and may mimic atrial myxoma. We present a case report of a man with a cardiac sarcoma.
Case report presentation.
A 68-year-old man with a permanent pacemaker presented to us with a 4-month history of breathlessness. Echocardiography revealed a large right atrial mass adherent to the pacemaker lead and a provisional diagnosis of atrial myxoma was made based on echocardiographic appearance. A 60 x 30 x 30 mm irregular lobulated tumour was surgically resected from the right atrium. Upon histopathologic examination, the tumour was consistent with an undifferentiated pleomorphic sarcoma.
Cardiac sarcomas have an extremely poor prognosis and more unfortunately this man developed a surgical site infection and died of acute mediastinitis. We discuss the presentation, imaging and current surgical approaches to cardiac sarcoma. Curative treatment is currently limited for this disease.
心脏肉瘤是一种罕见疾病，可能类似心房黏液瘤。我们报告一例患有心脏肉瘤的男性病例。
病例报告展示。
一名植入永久起搏器的68岁男性因气短4个月前来就诊。超声心动图显示一个附着于起搏器导线的巨大右心房肿物，基于超声心动图表现初步诊断为心房黏液瘤。从右心房手术切除一个60×30×30mm的不规则分叶状肿瘤。经组织病理学检查，该肿瘤符合未分化多形性肉瘤。
心脏肉瘤预后极差，更不幸的是，这名男性发生了手术部位感染并死于急性纵隔炎。我们讨论了心脏肉瘤的临床表现、影像学及当前的手术治疗方法。目前针对这种疾病的根治性治疗有限。
