Leung C Y, Cummings R G, Reimer K A, Lowe J E
Department of Surgery, Duke University Medical Center, Durham, NC 27710.
Ann Thorac Surg. 1988 Mar;45(3):291-5. doi: 10.1016/s0003-4975(10)62465-4.
This review summarizes the clinical manifestations and results of treatment of chondrosarcoma metastatic to the heart. Including the patient in the present report, a total of 18 patients have been reported. The most common site of cardiac metastasis was the right atrium. Dyspnea and pleuritic chest pain were the most common symptoms associated with cardiac metastases. The median time from the initial diagnosis of primary chondrosarcoma to death was 36 months, and the median time from the initiation of cardiac symptoms to death was 2 months. Treatment of primary chondrosarcoma included local radical resection in 14 patients. Treatment of cardiac metastases consisted of palliative support in 13 patients and surgical resection in 5 patients. Median survival following the development of cardiac symptoms was 2 months for patients treated nonsurgically and 18 months for those who underwent resection of cardiac metastases. The longest survival (24 and 28 months) was obtained in 2 patients with metastases confined to the heart that were successfully resected soon after development of cardiac symptoms. These results suggest that surgical resection of cardiac metastases in patients without widespread other metastases can result in substantial prolongation of life.
本综述总结了转移性心脏软骨肉瘤的临床表现及治疗结果。包括本报告中的患者在内，共计报告了18例患者。心脏转移最常见的部位是右心房。呼吸困难和胸膜性胸痛是与心脏转移相关的最常见症状。从原发性软骨肉瘤初诊至死亡的中位时间为36个月，从出现心脏症状至死亡的中位时间为2个月。14例原发性软骨肉瘤患者接受了局部根治性切除。13例心脏转移患者接受了姑息性支持治疗，5例接受了手术切除。出现心脏症状后，非手术治疗患者的中位生存期为2个月，接受心脏转移灶切除的患者为18个月。2例心脏转移局限且在出现心脏症状后不久成功切除的患者生存期最长（分别为24个月和28个月）。这些结果表明，对于无广泛其他转移的患者，手术切除心脏转移灶可显著延长生存期。
