Yamaguchi Ryo, Watanabe Masazumi, Ito Fusahiko, Kataoka Go
Department of Cardiovascular Surgery, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
Kyobu Geka. 2021 Dec;74(13):1078-1083.
Metastatic cardiac lesions are clinically silent and are usually found a necropsy. The most common primary tumor resulting in cardiac metastases is carcinoma of the lung, with there being only a few reports of metastases from esophageal cancer. We report two cases of metastatic cardiac tumors in the left atrium from esophageal cancer and perform a review of the literature. Case 1:A 62-year-old woman underwent esophagectomy and adjuvant chemotherapy. No other metastases were observed. Case 2:A 49-year-old man also underwent esophagectomy and adjuvant chemotherapy for lymph node and liver metastases. In both patients, the left atrial tumors were detected on recent follow-up computed tomography. Left atrial tumors often cause cerebral emboli with neurological sequelae. Therefore, surgical resection and cryo-ablation for the prevention of local recurrence were performed on the metastatic tumors. Local recurrence was not observed after the surgery in both patients. Although chemotherapy is usu-ally the most beneficial treatment for metastatic cardiac lesions, left atrial tumor should be treated with surgical resection because of the high risk of cerebral emboli. We suggest that surgical resection with cryo-ablation may prevent local recurrence.
转移性心脏病变在临床上没有症状，通常在尸检时才被发现。导致心脏转移的最常见原发肿瘤是肺癌，而食管癌转移的报道较少。我们报告两例食管癌转移至左心房的心脏肿瘤病例，并对相关文献进行综述。病例1：一名62岁女性接受了食管癌切除术及辅助化疗。未观察到其他转移灶。病例2：一名49岁男性因淋巴结和肝转移也接受了食管癌切除术及辅助化疗。在这两名患者中，近期的随访计算机断层扫描均发现了左心房肿瘤。左心房肿瘤常导致脑栓塞并遗留神经后遗症。因此，对转移性肿瘤进行了手术切除及冷冻消融以预防局部复发。两名患者术后均未观察到局部复发。虽然化疗通常是转移性心脏病变最有效的治疗方法，但由于脑栓塞风险高，左心房肿瘤应采用手术切除治疗。我们认为手术切除加冷冻消融可能预防局部复发。
