Lin S Y, Hsieh K Y, Hsieh M J, Chen W J, Fu M
Division of Cardiology, Department of Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1998 Mar;21(1):86-91.
Primary malignant mesenchymoma involving the heart is extremely rare. It usually has a poor prognosis. We report a case of malignant mesenchymoma originating in the left atrium with protrusion into the right pulmonary veins. Clinically, this patient presented with congestive heart failure, hemoptysis and systemic arterial embolization. Transthoracic and transesophageal echocardiography revealed a huge mass originating in the posterior wall of the left atrium with extension into both upper and lower right pulmonary veins. An elevated pulmonary arterial wedge pressure, moderate pulmonary hypertension and stenosis of the lower abdominal aorta were found during cardiac catheterization. Magnetic resonance imaging with angiography disclosed a tumor mass over the abdominal aorta above the bifurcation with protrusion into the right common iliac artery. This patient underwent surgical resection of the cardiac tumor and postoperative adjuvant chemotherapy. The pathological finding of a tumor containing several cellular types of sarcoma confirmed the diagnosis of malignant mesenchymoma.
原发性恶性间叶瘤累及心脏极为罕见。其预后通常较差。我们报告一例起源于左心房并突入右肺静脉的恶性间叶瘤病例。临床上，该患者表现为充血性心力衰竭、咯血和全身性动脉栓塞。经胸和经食管超声心动图显示一个巨大肿块起源于左心房后壁并延伸至右上和右下肺静脉。心脏导管检查发现肺动脉楔压升高、中度肺动脉高压和下腹主动脉狭窄。磁共振血管造影显示腹主动脉分叉上方有一个肿瘤肿块并突入右髂总动脉。该患者接受了心脏肿瘤手术切除及术后辅助化疗。肿瘤含有几种肉瘤细胞类型的病理结果证实了恶性间叶瘤的诊断。
