原发不明的黑色素瘤的非典型心脏部位

Atypical Cardiac Location of Melanoma of Unknown Origin.

作者信息

Styczeń Agnieszka, Kozak Mariusz, Karaś-Głodek Marta, Czekajska-Chehab Elżbieta, Tomaszewski Andrzej, Wysokiński Andrzej, Zapolski Tomasz

机构信息

Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland.

Department of Radiology, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland.

出版信息

Medicina (Kaunas). 2021 Jan 25;57(2):107. doi: 10.3390/medicina57020107.

DOI:10.3390/medicina57020107

PMID:33503841

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7911921/

Abstract

The subject was a 66-year-old woman, suffering from the chest pain evoked by physical activity. Transthoracic echocardiography (TTE) revealed an abnormal structure, 41 × 29 mm. In MSCT, a hypodensic mobile tissue lesion that was infiltrating the whole thickness of left ventricle was confirmed. PET excluded the existence of other remote lesions. After surgical tumor removal, histopathological differential diagnosis revealed melanoma, myoepithelial cancer, and MPNST "high-grade" sarcoma. A control TTE detected a tumor that was 14 × 10 mm. After immunohistochemical results, immunotherapy with pembrolizumab was used, which resulted in complete tumor resolution. Presently, surgical resection and neoadjuvant targeted immunochemotherapy remain the treatment of choice for clinical stage III/IV melanoma.

摘要

患者为一名66岁女性，患有因体力活动诱发的胸痛。经胸超声心动图（TTE）显示一个41×29毫米的异常结构。在多层螺旋CT（MSCT）中，证实存在一个低密度可移动组织病变，其浸润了左心室全层。正电子发射断层显像（PET）排除了其他远处病变的存在。手术切除肿瘤后，组织病理学鉴别诊断显示为黑色素瘤、肌上皮癌和“高级别”恶性周围神经鞘膜瘤（MPNST）肉瘤。对照TTE检测到一个14×10毫米的肿瘤。根据免疫组化结果，使用帕博利珠单抗进行免疫治疗，肿瘤完全消退。目前，手术切除和新辅助靶向免疫化疗仍然是临床III/IV期黑色素瘤的首选治疗方法。