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胸腺类癌罕见病例以胃肠道症状和心包积液为表现。

A rare case of thymic carcinoid presenting with gastrointestinal symptoms and pericardium effusion.

机构信息

Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, People's Republic of China.

Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, 410011, Hunan, People's Republic of China.

出版信息

BMC Cardiovasc Disord. 2021 Jan 28;21(1):54. doi: 10.1186/s12872-021-01871-4.

Abstract

BACKGROUND

Thymic carcinoid is one of an extremely rare type of malignant neuroendocrine tumor with a poor prognosis. Invasion of thymic carcinoid to other organs could lead to devastating consequences. It has been reported that thymic carcinoid mainly invaded to the pleura, lungs, liver, pancreas and bone, while rarely to the cardiac, especially to the ventricle.

CASE PRESENTATION

A 53-year-old man presented with gastrointestinal symptoms and persistent pericardial effusion. Multiple imaging tools, including chest computed tomography (CT), magnetic resonance imaging (MRI), 18F-Fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) showed a malignant neoplasm arising from the thymus invading into the biventricular myocardium, pericardium, and left superior pulmonary veins. The tumor was finally diagnosed as a thymic carcinoid through pathological examination.

CONCLUSION

This is a rare case of thymic carcinoid invading the ventricular myocardium, which presented as subacute heart failure. The observations in this case would be useful for differential diagnosis of primary heart disease and invasion of heart due to thymic carcinoid.

摘要

背景

胸腺癌是一种罕见的恶性神经内分泌肿瘤,预后不良。胸腺癌侵犯其他器官可能会导致严重后果。据报道,胸腺癌主要侵犯胸膜、肺、肝、胰腺和骨骼,而很少侵犯心脏,尤其是心室。

病例介绍

一名 53 岁男性因胃肠道症状和持续性心包积液就诊。多种影像学工具,包括胸部计算机断层扫描(CT)、磁共振成像(MRI)、18F-氟脱氧葡萄糖正电子发射断层扫描/CT(18F-FDG PET/CT)显示,一种来源于胸腺的恶性肿瘤侵犯了左右心室心肌、心包和左上肺静脉。通过病理检查,肿瘤最终被诊断为胸腺癌。

结论

这是一例罕见的胸腺癌侵犯心室心肌的病例,表现为亚急性心力衰竭。本病例的观察结果对于原发性心脏病和胸腺癌侵犯心脏的鉴别诊断具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a310/7844974/786624f9f59e/12872_2021_1871_Fig1_HTML.jpg

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