Shindo G, Mizuno A, Matsumoto H, Nakayama S, Matsunaga H, Miyawaki F, Asano K, Mizuno M, Funaki H
Nihon Geka Gakkai Zasshi. 1983 Sep;84(9):792-5.
Recent remarkable development of the non-invasive diagnostic apparatus such as two dimensional echocardiography, computed tomography and RI angiography improves early diagnosis for secondary cardiac tumors and promotes surgical treatments for them. Five cases of secondary intracardiac tumors underwent open heart surgery using cardiopulmonary bypass with successful removal. Although a case of direct invasion of a malignant thymoma into the pericardium, RA and SVC was lost at ICU after surgery because of massive hemorrhage followed by LOS, another 4 cases, i.e., a 27 year-old female with implantation of LA myxoma into the RA and RV, a case with intracavitary extension of leiomyosarcoma of the IVC, a case of intravenous extension of the uterine leiomyomatosis through the IVC to the pulmonary artery and a case of intravenous extension of chondrosarcoma of the left fibula to the heart are alive actively. Open heart surgery has become acceptable treatment for cases with secondary intracavitary cardiac tumors in order to rescue emergency cases with circulatory obstruction by the tumor mass, to make sure a pathological diagnosis of unknown origin and to promote further chemotherapy and/or radiation therapy after surgery. Our surgical results may support these active treatments for secondary cardiac tumors.
近年来，二维超声心动图、计算机断层扫描和放射性核素血管造影等无创诊断设备的显著发展，提高了继发性心脏肿瘤的早期诊断率，并推动了其外科治疗。5例继发性心内肿瘤患者在体外循环下接受了心脏直视手术，肿瘤均成功切除。尽管1例恶性胸腺瘤直接侵犯心包、右心房和上腔静脉的患者术后在重症监护病房因大出血继发多器官功能障碍综合征死亡，但另外4例患者存活良好，分别为1例27岁女性，左心房黏液瘤植入右心房和右心室；1例下腔静脉平滑肌肉瘤腔内扩展；1例子宫平滑肌瘤经下腔静脉静脉内扩展至肺动脉；1例左腓骨软骨肉瘤经静脉扩展至心脏。心脏直视手术已成为继发性心腔内肿瘤病例的可接受治疗方法，以挽救因肿瘤肿块导致循环梗阻的急症患者，明确不明来源的病理诊断，并促进术后进一步的化疗和/或放疗。我们的手术结果可能支持对继发性心脏肿瘤的这些积极治疗。
