Department of Molecular Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Department of Medical Oncology, Mayo Clinic, Rochester, MN 55905, USA.
Curr Oncol. 2024 Sep 12;31(9):5384-5398. doi: 10.3390/curroncol31090398.
Liposarcoma, one of the most prevalent sarcoma histologies, is recognized for its tendency for extra-pulmonary metastases. While oligometastatic cardiac disease is rarely reported, it poses a unique challenge as oligometastatic sarcomas are often managed with surgical resection.
We present a case of a 62-year-old man diagnosed with an oligometastatic myxoid liposarcoma (MLPS) to the heart 19 years after the primary tumor resection from the lower limb. The metastatic mass, situated in the pericardium adjacent and infiltrating the left ventricle, was not managed surgically but with a combination of chemotherapy and radiotherapy. The patient's disease remains stable to date, for more than 10 years.
We conducted a review of the literature to determine the preferred management approach for solitary cardiac metastases of sarcomas. We also conducted an in-depth analysis focusing on reported cases of MLPS metastasizing to the heart, aiming to extract pertinent data regarding the patient characteristics and the corresponding management strategies.
Although clinical diagnoses of solitary or oligometastatic cardiac metastases from sarcomas are infrequent, this case underscores the significance of aggressive management employing chemotherapy and radiotherapy for chemosensitive and radiosensitive sarcomas, especially when surgical removal is high-risk. Furthermore, it challenges the notion that surgery is the exclusive therapeutic option leading to long-term clinical benefit in patients with recurrent sarcomas.
脂肪肉瘤是最常见的肉瘤组织学类型之一，其特点是易发生肺外转移。虽然寡转移性心脏疾病很少见，但它是一个独特的挑战，因为寡转移性肉瘤通常通过手术切除来治疗。
我们报告了一例 62 岁男性患者，19 年前下肢原发性肿瘤切除后，诊断为多发性黏液样脂肪肉瘤（MLPS）的寡转移性心脏肿瘤。转移性肿块位于心包，紧邻左心室并浸润左心室，未进行手术治疗，而是采用化疗和放疗相结合的方法进行治疗。患者的病情至今仍保持稳定，已经超过 10 年。
我们对文献进行了回顾，以确定治疗肉瘤孤立性或寡转移性心脏转移的首选方法。我们还对报告的 MLPS 转移至心脏的病例进行了深入分析，旨在提取有关患者特征和相应管理策略的相关数据。
尽管临床诊断为肉瘤的孤立性或寡转移性心脏转移较为罕见，但本例强调了采用化疗和放疗治疗化疗和放疗敏感的肉瘤的重要性，尤其是在手术切除风险较高的情况下。此外，它挑战了手术是复发性肉瘤患者获得长期临床获益的唯一治疗选择的观点。
