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碳离子放疗治疗原发性心脏梭形细胞肉瘤:病例报告

Primary spindle cell sarcoma of the heart treated with carbon-ion radiotherapy: Case report.

作者信息

Shibasaki Ikuko, Toyoda Shigeru, Takei Yusuke, Chida Masayuki, Fukuda Hirotsugu

机构信息

Department of Cardiac and Vascular Surgery, Dokkyo Medical University, Tochigi, Japan.

Department of Cardiovascular Medicine, Dokkyo Medical University, Tochigi, Japan.

出版信息

Int J Surg Case Rep. 2020;76:1-4. doi: 10.1016/j.ijscr.2020.09.160. Epub 2020 Sep 25.

Abstract

INTRODUCTION

Primary cardiac sarcoma is a rare malignant cardiac neoplasm with a poor prognosis. No evidence-based guidelines exist regarding surgical treatment management, although some case reports have been published. We report the outcome of a patient with spindle cell sarcoma of the heart treated postoperatively with carbon-ion radiotherapy and chemotherapy.

PRESENTATION OF CASE

A 16-year-old female patient was noted to have abnormal electrocardiogram results for 2 consecutive years at a high school medical check. She was referred to our hospital and a cardiac tumor in the left atrium was suspected. The preoperative diagnosis was myxoma, but abnormalities were also observed macroscopically during surgery, and a diagnosis of spindle cell sarcoma was made by rapid intraoperative pathological analysis. We resected the tumor as much as possible with surgery, but the tumor in the left lower pulmonary vein could not be respected. We performed carbon-ion radiotherapy postoperatively. She experienced recurrence 1 year later and tumor growth 2 years later. We considered additional surgical treatment, but eventually selected chemotherapy. She died 4 years and 7 months after initial surgery.

CONCLUSION

Spindle cell sarcoma is a rare disease with a poor prognosis. Although no optimal treatment method has been established, in the present case, incomplete surgical resection and postoperative carbon-ion radiotherapy were performed, yielding a relatively long survival period.

摘要

引言

原发性心脏肉瘤是一种罕见的恶性心脏肿瘤,预后较差。尽管已有一些病例报告发表,但关于手术治疗管理尚无循证指南。我们报告了一例心脏梭形细胞肉瘤患者术后接受碳离子放疗和化疗的结果。

病例介绍

一名16岁女性患者在高中体检时连续两年心电图结果异常。她被转诊至我院,怀疑左心房有心脏肿瘤。术前诊断为黏液瘤,但手术中肉眼也观察到异常,术中快速病理分析诊断为梭形细胞肉瘤。我们手术尽可能切除肿瘤,但左肺下静脉的肿瘤无法切除。术后我们进行了碳离子放疗。她1年后复发,2年后肿瘤生长。我们考虑再次手术治疗,但最终选择了化疗。她在初次手术后4年7个月死亡。

结论

梭形细胞肉瘤是一种罕见疾病,预后较差。虽然尚未确立最佳治疗方法,但在本病例中,进行了不完全手术切除和术后碳离子放疗,生存期相对较长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/283b/7528050/5906b04214b8/gr1.jpg

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