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肺动脉肉瘤广泛侵犯右心室:病例报告及治疗选择回顾。

Pulmonary Artery Sarcoma with Extensive Invasion of the Right Ventricle: A Case Report and Review of Therapeutic Options.

机构信息

Department of Cardiovascular Surgery, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.

Department of Cardiology, Clinique Notre Dame de Grâce, Gosselies, Charleroi, Belgium.

出版信息

Ann Thorac Cardiovasc Surg. 2024;30(1). doi: 10.5761/atcs.cr.24-00106.

Abstract

Pulmonary artery sarcoma (PAS) is a rare, aggressive cancer originating from the intimal layer of the pulmonary artery (PA), often mistaken for pulmonary thromboembolism. This case report underscores the complex management of PAS and the necessity of a multidisciplinary approach for accurate diagnosis and treatment. A 52-year-old woman with PAS was diagnosed using imaging and therapeutic tests to distinguish it from pulmonary embolism. Primary treatment included surgical resection of the pulmonary trunk, valve, and tumor, followed by reconstruction. Complete resection was impossible due to extensive endocardial infiltration in the right ventricle, precluding cardiac transplant. The patient underwent adjuvant radiotherapy; however, the disease recurred, and she died 3 years post-diagnosis. This case highlights the rarity of an extensive right ventricle invasion, the absence of clear PAS management guidelines, and the limited evidence on the effectiveness of adjuvant therapies. It concludes that multidisciplinary teams are vital for decision-making and stresses the need for further research to establish effective treatment protocols.

摘要

肺动脉肉瘤(PAS)是一种罕见的侵袭性癌症,起源于肺动脉(PA)的内膜层,常被误诊为肺血栓栓塞症。本病例报告强调了 PAS 的复杂管理以及多学科方法对于准确诊断和治疗的必要性。

一名 52 岁女性被诊断为 PAS,采用影像学和治疗性检查来区分 PAS 和肺栓塞。主要治疗方法包括手术切除肺动脉干、瓣膜和肿瘤,然后进行重建。由于右心室心内膜广泛浸润,无法进行完全切除,因此排除了心脏移植。患者接受了辅助放疗;然而,疾病复发,她在诊断后 3 年去世。

本病例突出了广泛右心室浸润的罕见性、缺乏明确的 PAS 管理指南以及辅助治疗效果的有限证据。结论认为,多学科团队对于决策至关重要,并强调需要进一步研究以建立有效的治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a20/11550908/66dae4bee10d/atcs-30-1-24-00106-figure01.jpg

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