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右心房心脏血管肉瘤经手术切除治疗。

Cardiac Angiosarcoma in the Right Atrium Treated by Surgical Resection.

机构信息

Institute for Cardiovascular Diseases "Dedinje", 11000 Belgrade, Serbia.

Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.

出版信息

Medicina (Kaunas). 2024 Aug 15;60(8):1321. doi: 10.3390/medicina60081321.

Abstract

We present the case of a 49-year-old female of Caucasian European descent with chest tightness, fatigue, and palpitations, ultimately diagnosed with primary intracardiac angiosarcoma. Initial echocardiography revealed a significant mass within the right atrium, infiltrating the free wall. Surgical intervention included tumor excision and partial resection of the superior vena cava. Histopathological examination confirmed a high-grade angiosarcoma. Postoperative imaging identified a recurrent mass in the right atrium, suggestive of thrombus, alongside Takotsubo cardiomyopathy. Considering the elevated surgical risks and the presence of cardiomyopathy, management included anticoagulation therapy with Warfarin and adjuvant chemotherapy with Paclitaxel. Follow-up cardiac magnetic resonance imaging demonstrated a recurrent angiosarcoma with superimposed thrombus. This case presents the complex diagnostic and therapeutic landscape of angiosarcoma, highlighting the critical importance of early surgical intervention, advanced imaging techniques, and vigilant postoperative monitoring.

摘要

我们报告了一例 49 岁的高加索裔白人女性,她有胸闷、疲劳和心悸的症状,最终被诊断为原发性心脏血管肉瘤。初步超声心动图显示右心房内有一个显著的肿块,浸润了游离壁。手术干预包括肿瘤切除和上腔静脉部分切除。组织病理学检查证实为高级别血管肉瘤。术后影像学检查发现右心房内有复发性肿块,提示血栓形成,同时伴有 Takotsubo 心肌病。考虑到手术风险较高且存在心肌病,治疗包括华法林抗凝治疗和紫杉醇辅助化疗。随访心脏磁共振成像显示复发性血管肉瘤伴血栓形成。本病例展示了血管肉瘤复杂的诊断和治疗情况,强调了早期手术干预、先进的影像学技术和术后监测的重要性。

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