Dong Weikai, Du Zhaoqi, Liu Dianxiao, Yang Lijuan, Li Wei
Department of Cardiovascular Surgery, Binzhou Medical University Hospital, Binzhou, Shandong, China.
Department of Medical Research Center, Binzhou Medical University Hospital, Binzhou, Shandong, China.
Front Oncol. 2025 Jul 17;15:1567625. doi: 10.3389/fonc.2025.1567625. eCollection 2025.
The research into cardiac tumors can be traced back to the 18th century, when Bonet first introduced the relevant concept. It was not until 1936 that the first successful resection of a cardiac tumor was performed. From a pathological origin perspective, cardiac tumors can be categorized into two main types: primary tumors, which originate from the heart itself, and secondary tumors, which result from metastases of malignant tumors in other tissues or organs. Primary cardiac tumors are exceedingly rare, among primary cardiac tumors, roughly 75% are benign, while the remainder are malignant. In contrast, approximately 75% of primary malignant cardiac tumors are sarcomas. Cardiac myxoid fibrosarcoma stands out as a particularly rare diagnosis in this domain.
Case one: A 25-year-old man presented with chest pain and tightness. After initial treatment, his symptoms recurred and worsened. Imaging revealed a large mass in the left atrium obstructing the mitral valve. He underwent surgical resection of the tumor, thrombectomy, and tricuspid valvuloplasty. Pathology diagnosed myxoid fibrosarcoma. The patient was readmitted 7 months later with hemoptysis due to tumor recurrence and was lost to follow-up after symptomatic treatment. Case two: A 67-year-old woman was admitted with cough, chest tightness, and shortness of breath. Physical examination and imaging showed a mass in the left atrium causing mitral valve obstruction. She underwent surgical resection of the tumor. Pathology confirmed myxoid fibrosarcoma. After 6 months of follow-up, there was no tumor recurrence or metastasis.
Myxoid fibrosarcoma located in the left atrium can lead to mitral valve obstruction, causing symptoms of mitral stenosis such as dyspnea, cough, hemoptysis, and reduced exercise tolerance. Surgery remains the primary treatment for primary left atrial malignant tumors. Once the diagnosis is confirmed, active surgical intervention should be performed to relieve blood flow obstruction, remove pericardial effusion, and alleviate cardiac compression, which can extend patients' lives in the short term and improve their quality of life. Despite advancements in diagnostic techniques and surgical methods, the prognosis for patients with cardiac tumors still depends on the histology and location of the tumor.
对心脏肿瘤的研究可追溯到18世纪，当时博内首次引入了相关概念。直到1936年才首次成功切除心脏肿瘤。从病理起源角度来看，心脏肿瘤可分为两大类：原发性肿瘤，即起源于心脏本身；继发性肿瘤，即由其他组织或器官的恶性肿瘤转移所致。原发性心脏肿瘤极为罕见，在原发性心脏肿瘤中，约75%为良性，其余为恶性。相比之下，原发性恶性心脏肿瘤中约75%为肉瘤。心脏黏液样纤维肉瘤在该领域是一种特别罕见的诊断。
病例一：一名25岁男性出现胸痛和胸闷。初始治疗后，症状复发且加重。影像学检查显示左心房有一个大肿块，阻塞二尖瓣。他接受了肿瘤手术切除、血栓切除术和三尖瓣成形术。病理诊断为黏液样纤维肉瘤。患者7个月后因肿瘤复发咯血再次入院，经对症治疗后失访。病例二：一名67岁女性因咳嗽、胸闷和气短入院。体格检查和影像学检查显示左心房有一个肿块，导致二尖瓣阻塞。她接受了肿瘤手术切除。病理证实为黏液样纤维肉瘤。随访6个月后，无肿瘤复发或转移。
位于左心房的黏液样纤维肉瘤可导致二尖瓣阻塞，引起二尖瓣狭窄症状，如呼吸困难、咳嗽、咯血和运动耐量降低。手术仍然是原发性左心房恶性肿瘤的主要治疗方法。一旦确诊，应积极进行手术干预，以解除血流梗阻、清除心包积液并减轻心脏压迫，这可在短期内延长患者生命并提高其生活质量。尽管诊断技术和手术方法有所进步，但心脏肿瘤患者的预后仍取决于肿瘤的组织学类型和位置。
