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以心脏压塞为表现的心脏肉瘤

Cardiac Sarcoma Presenting as Tamponade.

作者信息

Oyenuga Mosunmoluwa, Sen Sandeep, Patel Rushin, Ali Shahin, Sartaj Sara, Lacasse Alexandre

机构信息

Department of Internal Medicine, SSM St. Mary's Hospital, St. Louis, MO, USA.

Division of Hematology/Oncology, SSM St. Mary's Hospital, St. Louis, MO, USA.

出版信息

J Community Hosp Intern Med Perspect. 2022 Sep 9;12(5):106-109. doi: 10.55729/2000-9666.1106. eCollection 2022.

Abstract

Sarcomas are a broad group of neoplasm that originate from the mesenchymal layer and represent about 1% of malignancy in the adult population. We describe a 46-year-old woman with no prior medical history who presented with worsening dyspnea. Physical examination was significant for jugular venous distension and bilateral lower extremity edema. Chest Xray showed cardiomegaly. Echocardiography showed a normal ejection fraction of 65%, pericardial effusion with tamponade physiology and three epicardial masses. Patient had pericardiocentesis performed followed by pericardial window. Biopsy of pericardial mass showed morphologic and immunophenotypic findings supportive of diagnosis of malignant soft tissue sarcoma. Though this type of cancer is rare, malignancy should be included as one of the differential diagnoses of new-onset pericardial effusion in a young patient. Early diagnosis and referral to a specialized sarcoma center for treatment is recommended.

摘要

肉瘤是一大类起源于间充质层的肿瘤,约占成年人群恶性肿瘤的1%。我们描述了一名46岁无既往病史的女性,她出现了进行性加重的呼吸困难。体格检查发现颈静脉怒张和双侧下肢水肿。胸部X光显示心脏扩大。超声心动图显示射血分数正常,为65%,存在心包积液伴心脏压塞生理表现以及三个心外膜肿块。患者接受了心包穿刺术,随后进行了心包开窗术。心包肿块活检显示形态学和免疫表型结果支持恶性软组织肉瘤的诊断。尽管这种癌症很罕见,但在年轻患者新发心包积液的鉴别诊断中应将恶性肿瘤纳入其中。建议早期诊断并转诊至专业肉瘤中心进行治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d93b/9529657/db1a21422799/jchim-12-05-106f1.jpg

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