Boey S, Tribouilloy C, Lesbre J P, Stankowiak C, Copin M C, Haffreingue E, Espriet G
Service de cardiologie, Clinique du Parc, Croix.
Arch Mal Coeur Vaiss. 1994 Feb;87(2):291-4.
The authors report a case of left atrial leiomyosarcoma presenting with systemic disturbances and retinal emboli diagnosed by echocardiography and surgery in a 59 year old woman. Surgical ablation was completed by a course of chemotherapy. Histopathological examination confirmed the diagnosis of sarcoma; although the patient remained generally well, severe mitral regurgitation appeared 21 months after surgery. Transoesophageal echocardiography revealed an abnormal, hyper-mobile, intra-atrial echo suggesting a ruptured chordae tendinae and the mitral valves appeared very thickened and retracted. The patient was reoperated and the mitral valve replaced with a bioprosthesis. After a total follow-up of 29 months, the patients is still alive and asymptomatic. The authors underline the importance of echocardiography in the diagnosis of intra-cardiac tumours in general and, in particular, of intra-cardiac sarcomas.
作者报告了一例59岁女性的左心房平滑肌肉瘤病例,该患者表现为全身不适和视网膜栓塞,通过超声心动图和手术确诊。通过化疗疗程完成了手术消融。组织病理学检查确诊为肉瘤;尽管患者总体状况良好,但术后21个月出现了严重的二尖瓣反流。经食管超声心动图显示心房内有异常的、活动过度的回声,提示腱索断裂,二尖瓣显得非常增厚和缩短。患者接受了再次手术,二尖瓣被生物假体置换。经过29个月的总随访,患者仍然存活且无症状。作者强调了超声心动图在一般心脏内肿瘤诊断中的重要性,尤其是心脏内肉瘤的诊断。