Ishiko R, Yamasaki J, Kasahara T, Kosaka T, Kotake H, Furuse T, Mashiba H
First Department of Internal Medicine, Tottori University School of Medicine, Yonago.
J Cardiol. 1987 Sep;17(3):653-8.
Cardiac metastases have been reported increasingly partly because of the longevity of cancer patients, but its antemortem diagnosis is frequently missed. This is due to the nonspecific clinical manifestations or relative lack of characteristic signs which are masked by the underlying disease. This is a report of a 42-year-old man diagnosed as having a metastatic cardiac tumor by echocardiography, six months after operation for squamous cell carcinoma of the gall bladder. Echocardiography revealed abnormal structures in the regions of the posterior and lateral walls of the left ventricle and interventricular septum, suggesting metastatic tumors. The cytological findings of a fine-needle aspiration biopsy specimen were squamous cell carcinoma. The patient died of cardiac failure eight months after the echocardiographic diagnosis. At autopsy, the abnormal structures in the heart were identified as cardiac metastatic tumors from gall bladder cancer. Reports of cardiac metastasis of gall bladder cancer is very rare (0-3%). The myocardial metastasis may have a more serious prognostic importance than the primary neoplasm itself; thus, its definite diagnosis is mandatory.
心脏转移瘤的报道日益增多,部分原因是癌症患者寿命延长,但生前诊断常常被漏诊。这是由于临床表现不具特异性,或相对缺乏特征性体征,且被基础疾病所掩盖。本文报告一例42岁男性,在胆囊鳞状细胞癌手术后6个月,经超声心动图诊断为心脏转移瘤。超声心动图显示左心室后壁、侧壁及室间隔区域结构异常,提示转移瘤。细针穿刺活检标本的细胞学检查结果为鳞状细胞癌。超声心动图诊断8个月后,患者死于心力衰竭。尸检时,心脏的异常结构被确认为胆囊癌的心脏转移瘤。胆囊癌心脏转移的报道非常罕见(0% - 3%)。心肌转移可能比原发性肿瘤本身具有更严重的预后意义;因此,明确诊断至关重要。