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广泛原发性心脏肉瘤手术切除后实现完全临床康复

Complete Clinical Recovery Following Surgical Excision of Extensive Primary Cardiac Sarcoma.

作者信息

Muenker Kai A, Schoeni Hannah, Beyer Joerg, Kadner Alexander

机构信息

Department of Cardiac Surgery, University Hospital Bern, Bern, Switzerland.

Department of Oncology, University Hospital Bern, Bern, Switzerland.

出版信息

JACC Case Rep. 2024 Dec 4;29(23):102832. doi: 10.1016/j.jaccas.2024.102832.

Abstract

Primary cardiac tumors are rare, most of them being benign. Most malignant cardiac tumors are sarcomas, with the most important therapeutic option being surgery, along with perioperative chemo- and radiotherapy. Here, we present a case of a 67-year-old female patient with no prior medical condition, who presented with primary cardiac sarcoma and extensive tumor growth in the pulmonary artery. Debulking of the tumor mass was performed, along with pulmonary valve replacement, tricuspid valve reconstruction, and patent foramen ovale closure. This was followed by adjuvant radiotherapy. The patient remains in remission with an excellent clinical status after 18 months. Despite surgery, previous register studies on cardiac sarcomas have reported a median survival that typically does not exceed 2 years. Given this poor prognosis, surgical therapy is sometimes not carried out. Despite this, in our case, surgical tumor debulking in combination with radiotherapy relieved symptoms and the patient is in good health 18 months later.

摘要

原发性心脏肿瘤很罕见,其中大多数是良性的。大多数恶性心脏肿瘤是肉瘤,最重要的治疗选择是手术,以及围手术期化疗和放疗。在此,我们报告一例67岁女性患者,既往无病史,该患者患有原发性心脏肉瘤且肺动脉有广泛肿瘤生长。进行了肿瘤减容手术,同时进行了肺动脉瓣置换、三尖瓣重建和卵圆孔未闭封堵术。随后进行了辅助放疗。18个月后,患者仍处于缓解期,临床状态良好。尽管进行了手术,但先前关于心脏肉瘤的登记研究报告的中位生存期通常不超过2年。鉴于这种不良预后,有时不进行手术治疗。尽管如此,在我们的病例中,手术肿瘤减容联合放疗缓解了症状,18个月后患者健康状况良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfbd/11646901/2fae32b04df3/ga1.jpg

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