Rojas M, Hadrami J, Mesnildrey P, Houlle D, Chotard Y
Service de cardiologie, centre hospitalier de Courbevoie-Neuilly-sur-Seine.
Arch Mal Coeur Vaiss. 1998 Oct;91(10):1289-93.
The authors report the case of a right atrial angiosarcoma extending to the right ventricle, presenting with a massive pericardial effusion, in a 30 year old man. The patient underwent surgical ablation of the tumour with right atrial reconstruction, tricuspid valvuloplasty, plicature of the right ventricle and a right coronary artery bypass graft with complementary chemotherapy. This case illustrates the decisive contribution of multiplane transoesophageal echocardiography in the preoperative investigation, providing accurate information about the site and extension of the tumour, and even about the malignant character of the pathology. Magnetic resonance imaging, though useful, did not provide any further information in this case. Unfortunately, thoracic CT scan, performed 15 days after surgery, showed the presence of pulmonary metastases, confirming the very poor prognosis of these tumours.
作者报告了一例30岁男性患者,患有累及右心室的右心房血管肉瘤,并伴有大量心包积液。患者接受了肿瘤手术切除,同时进行了右心房重建、三尖瓣成形术、右心室折叠术以及右冠状动脉搭桥术,并辅以化疗。该病例说明了多平面经食管超声心动图在术前检查中的决定性作用,它能提供有关肿瘤部位和范围的准确信息,甚至能提供有关病理恶性特征的信息。磁共振成像虽然有用,但在该病例中并未提供更多信息。不幸的是,术后15天进行的胸部CT扫描显示存在肺转移,证实了这些肿瘤的预后极差。