Beghetti M, Gow R M, Haney I, Mawson J, Williams W G, Freedom R M
Division of Cardiology, The Hospital for Sick Children and the Faculty of Medicine, University of Toronto, Ontario, Canada.
Am Heart J. 1997 Dec;134(6):1107-14. doi: 10.1016/s0002-8703(97)70032-2.
An increase in the incidence of primary cardiac tumors has been reported since the development or enhancement of noninvasive imaging modalities. We identified 56 children with primary cardiac tumors. Forty-four (78%) children had rhabdomyomas, 6 (11%) fibromas, 1 (2%) pericardial teratoma, 1 (2%) epicardial lipoma, 1 (2%) multicystic hamartoma, and 3 (5%) unspecified tumors. The mean age at diagnosis was 19 +/- 35 months (median 4.7 months, range 0.03 to 204 months), excluding 12 patients who were given the diagnosis before birth. Among 27,640 patients assessed for cardiac disease, the incidence of tumors was 0.06% (1980 to 1984), 0.22% (1985 to 1989), and 0.32% (1990 to 1995). Diagnosis was made in 55 of 56 patients by echocardiography. Catheterization was performed in five patients and magnetic resonance imaging in nine. No tumor-related deaths occurred. Nine patients had surgery because of hemodynamically significant obstruction or arrhythmias. Partial or complete regression occurred in 24 (54%) of 44 patients with rhabdomyomas. Overall, the prognosis was excellent. Individualized surgery allowed early safe treatment of symptomatic tumors.
自从无创成像技术发展或改进以来,原发性心脏肿瘤的发病率已有报道称有所上升。我们确定了56例患有原发性心脏肿瘤的儿童。44例(78%)儿童患有横纹肌瘤,6例(11%)患有纤维瘤,1例(2%)患有心包畸胎瘤,1例(2%)患有心外膜脂肪瘤,1例(2%)患有多囊性错构瘤,3例(5%)为未明确的肿瘤。诊断时的平均年龄为19±35个月(中位数4.7个月,范围0.03至204个月),不包括12例在出生前就被诊断的患者。在27640例接受心脏病评估的患者中,肿瘤的发病率在1980至1984年为0.06%,1985至1989年为0.22%,1990至1995年为0.32%。56例患者中有55例通过超声心动图确诊。5例患者进行了心导管检查,9例进行了磁共振成像检查。未发生与肿瘤相关的死亡。9例患者因血流动力学上有显著梗阻或心律失常而接受了手术。44例横纹肌瘤患者中有24例(54%)发生了部分或完全消退。总体而言,预后极佳。个体化手术可对有症状的肿瘤进行早期安全治疗。