Tumors of the heart and pericardium.
Tumors of the heart and pericardium.
复制标题
心脏和心包肿瘤。
DOI：
10.1016/0305-7372(88)90001-1
复制
发表时间：
1988
影响因子：
11.8
通讯作者：
Urba,WJ
中科院分区：
文献类型：
--
作者：
Wilding,G;Green,HL;Longo,DL;Urba,WJ
肿瘤对心脏和心包的侵犯是癌症患者发病率的重要原因。尽管在所有癌症患者中仅有107例存在，但有三分之一的心包或心脏转移患者将直接死于这种累及。心脏和心包的恶性肿瘤可分为心脏和心包的原发性肿瘤和作为起源于其他器官的肿瘤的转移性或直接延伸而出现的肿瘤。原发性肿瘤是罕见的，通常表现为心力衰竭或瓣膜功能障碍的症状，没有明显的恶性病因证据。心脏和心包的继发性或转移性受累更常见。肺癌和乳腺癌，因为它们的高患病率和接近心脏，是心脏受累的最常见来源，其次是黑色素瘤和血液恶性肿瘤。死前诊断总是低估心脏受累的存在。死前诊断与死后诊断的差异可能是由于恶性病变的隐匿性，原发性冠状动脉或瓣膜病变的肿瘤的模拟，或通过广泛转移性疾病的体征和症状掩盖心脏疾病。诊断的关键是在适当的临床环境中保持高度怀疑指数，并应用非-侵入性和侵入性方式来进行诊断。超声心动图（56例）、计算机断层扫描（72例）、磁共振成像（3例）和心导管检查及肌内膜活检（18例）均导致了准确的诊断。
Tumor invasion of the heart and pericardium accounts for a significant degree ofmorbidity in cancer patients. Although present in only 107; of all cancer patients, fully one-third of patients with pericardial or cardiac metastases will die as a direct result ofthis involvement. Malignant tumors of the heart and pericardium can be divided into primary tumors of the heart and pericardium and those arising as metastatic or direct extensions of tumors originating in other organs. Primary tumors are rare and often present with symptoms of cardiac failure or valvular dysfunction without obvious evidence for a malignant etiology. Secondary or metastatic involvement of the heart and pericardium occurs much more commonly. Carcinomas of the lung and breast, because of their high prevalence and proximity to the heart, are the most frequent sources of cardiac involvement followed by melanoma and the hematologic malignancies. Antemortem diagnoses invariably underestimate the presence of cardiac involvement. The discrepancy between antemortem and postmortem diagnoses may be the result of the silent nature of the malignant involvement, simulation by the tumor of primary coronary artery or valvular disease, or obscuring of cardiac disease by the signs and symptoms of widespread metastatic disease.The key to diagnosis is the maintenance of a high index of suspicion in the appropriate clinical setting with the application ofnon-invasive and invasive modalities in pursuit of the diagnosis. Echocardiography(56)) computerized tomography(72), magnetic resonance imaging (3) and cardiac catheterization with endomyocardial biopsy (18) have all led to accurate diagnosis.