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心脏血管肉瘤:一项诊断与治疗挑战。

Cardiac angiosarcoma: A diagnostic and therapeutic challenge.

作者信息

Krishnan Tharani, Pettersson Gosta, Mukherjee Rahul, Singhal Nimit

机构信息

Medical Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.

Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA.

出版信息

J Cardiol Cases. 2020 May 14;22(2):90-93. doi: 10.1016/j.jccase.2020.04.010. eCollection 2020 Aug.

Abstract

Cardiac angiosarcomas are a rare group of soft tissue sarcomas, characterized by aggressive local growth and early spread. Because this is an uncommon disease, there is currently no standard treatment approach. When localized, surgery appears to lead to the best outcomes, but this can be technically challenging and not always feasible. Upfront chemoradiotherapy provides an alternative that may shrink the tumor to enable definitive surgical resection. We report a case of primary cardiac angiosarcoma with a complete metabolic and pathological response after upfront chemoradiotherapy with paclitaxel, who then underwent surgery, as a potential treatment option for patients with this rare condition. < Cardiac angiosarcoma can present with non-specific symptoms and signs making early diagnosis difficult. When localized, surgery provides the best survival outcomes for patients, but may not be possible due to the extent of invasion into surrounding critical structures. In this case of locally advanced disease in a young patient, there was the opportunity to treat this tumor aggressively with upfront combined chemoradiotherapy followed by surgery, with a dramatic response observed.>.

摘要

心脏血管肉瘤是一组罕见的软组织肉瘤,其特点是局部生长侵袭性强且早期易扩散。由于这是一种罕见疾病,目前尚无标准治疗方法。肿瘤局限时,手术似乎能带来最佳疗效,但这在技术上具有挑战性,且并非总是可行。术前放化疗提供了一种替代方案,可使肿瘤缩小以便进行根治性手术切除。我们报告一例原发性心脏血管肉瘤患者,在接受紫杉醇术前放化疗后出现完全代谢和病理反应,随后接受了手术,这作为这种罕见疾病患者的一种潜在治疗选择。<心脏血管肉瘤可能表现为非特异性症状和体征,导致早期诊断困难。肿瘤局限时,手术为患者提供最佳生存结局,但由于肿瘤侵犯周围关键结构的范围,手术可能无法进行。在该例年轻患者的局部晚期疾病中,有机会通过术前联合放化疗积极治疗该肿瘤,随后进行手术,并观察到显著反应。>

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