Naruse Genki, Kawasaki Masanori, Yanase Komei, Tanaka Toshiki
Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan.
Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan.
J Med Ultrasound. 2020 Feb 19;28(2):120-122. doi: 10.4103/JMU.JMU_93_19. eCollection 2020 Apr-Jun.
A 47-year-old woman consulted a doctor due to a persistent cough. Computed tomography revealed a 30 mm × 60 mm intracardiac mass in the right atrium. Because of lung metastasis, her respiratory status did not allow a more invasive procedure, such as general anesthesia. Although intracardiac echocardiography (ICE) during percutaneous transcatheter biopsy (PTB) is not covered by medical insurance, we performed PTB under ICE guidance. Pathology and immunohistochemistry revealed primary cardiac angiosarcoma. Primary cardiac angiosarcoma is a rare tumor with a poor prognosis. After seven cycles of chemotherapy, the pulmonary metastasis was clearly improved. The patient is alive 18 months after the first consult, even though the mortality of angiosarcoma is high. ICE during PTB allowed us to choose appropriate chemotherapy and improve her pulmonary metastasis. ICE during PTB reduces the need for a diagnostic open-chest procedure that requires a more invasive approach.
一名47岁女性因持续咳嗽就医。计算机断层扫描显示右心房有一个30毫米×60毫米的心内肿块。由于发生了肺转移，她的呼吸状况不允许进行更具侵入性的手术，如全身麻醉。尽管经皮经导管活检（PTB）期间的心内超声心动图（ICE）不在医保范围内，但我们在ICE引导下进行了PTB。病理和免疫组化显示为原发性心脏血管肉瘤。原发性心脏血管肉瘤是一种罕见肿瘤，预后较差。经过七个周期的化疗，肺转移明显改善。尽管血管肉瘤死亡率很高，但该患者在首次就诊后18个月仍存活。PTB期间的ICE使我们能够选择合适的化疗方案并改善她的肺转移情况。PTB期间的ICE减少了对需要更具侵入性方法的诊断性开胸手术的需求。
