Guerra-Raygada Mauricio, Saavedra-Sanchez Alee Jonhson, Hidalgo-Avendaño Diego, Bermudez-Pelaez Milagros F, Guevara-Lazo David, Nombera-Aznaran Natalia
Hospital Nacional Arzobispo Loayza, Lima, Peru.
Department of Medical Specialties, Cardiology and Coronary Care Service, Lima, Peru.
Egypt Heart J. 2024 Jul 6;76(1):86. doi: 10.1186/s43044-024-00520-3.
Sarcomas are the most common type of cardiac malignancy, but they are extremely rare. Within this group, angiosarcomas have the highest frequency, followed by undifferentiated sarcomas. This type of tumor has a poor prognosis and a high recurrence rate. Information about these tumors is limited, relying mainly on case reports and autopsy series. The purpose of this case report is to detail the multifaceted approach to diagnosing and managing an undifferentiated cardiac sarcoma and contribute to the literature.
A 28-year-old man presented with dyspnea and chest pain, which had developed progressively over several weeks. Physical examination revealed low blood pressure, elevated heart rate, and diminished heart sounds. Imaging, including a CT scan, identified a hypodense mass in the right ventricle. Further evaluation through echocardiograms and contrast angiotomography confirmed a mass causing right ventricular obstruction. Part of the tumor was surgically removed and diagnosed as cardiac sarcoma. Histopathological analysis of the mass showed an undifferentiated cardiac sarcoma.
This case underscores the significance of including cardiac tumors as a potential cause when diagnosing cardiac masses. It also demonstrates the poor prognosis and tendency for recurrence, while revealing the absence of established management guidelines.
肉瘤是最常见的心脏恶性肿瘤类型，但极为罕见。在这一肿瘤类别中，血管肉瘤最为常见，其次是未分化肉瘤。这类肿瘤预后较差，复发率高。关于这些肿瘤的信息有限，主要依赖病例报告和尸检系列。本病例报告的目的是详细阐述诊断和管理未分化心脏肉瘤的多方面方法，并为文献提供资料。
一名28岁男性出现呼吸困难和胸痛症状，持续数周且逐渐加重。体格检查发现血压低、心率加快且心音减弱。包括CT扫描在内的影像学检查发现右心室有一个低密度肿块。通过超声心动图和造影血管造影进一步评估证实有一个肿块导致右心室梗阻。部分肿瘤通过手术切除，诊断为心脏肉瘤。对肿块的组织病理学分析显示为未分化心脏肉瘤。
本病例强调了在诊断心脏肿块时将心脏肿瘤作为潜在病因的重要性。它还显示了预后不良和复发倾向，同时揭示了缺乏既定的管理指南。
