MALIGNANT PRIMARY CARDIAC TUMORS - THE CLEVELAND-CLINIC EXPERIENCE, 1956 TO 1986
MALIGNANT PRIMARY CARDIAC TUMORS - THE CLEVELAND-CLINIC EXPERIENCE, 1956 TO 1986
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DOI：
10.1378/chest.92.5.860
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发表时间：
1987-11-01
期刊：
影响因子：
9.6
通讯作者：
MOODIE, DS
中科院分区：
文献类型：
--
作者：
BEAR, PA;MOODIE, DS
恶性原发性心脏肿瘤的长期生存率普遍较低。我们回顾了1956年至1986年间11例此类肿瘤患者的资料。有5名男性和6名女性，平均年龄为44岁。11名患者中有9名（82%）最初出现呼吸道症状，45%（5名）出现胸痛。没有病人在初次就诊时无症状。百分之四十五（5）的患者有颈静脉压升高或收缩期杂音。11例患者中有8例（73%）存在心脏肥大。10例患者中有9例血红蛋白水平低于12 g/100 ml，30%（3/10）出现血小板增多。百分之七十（八）的患者进行了手术活检，并在百分之三十（三），手术切除肿瘤的尝试。血管肉瘤是最常见的肿瘤类型（4例患者），其次是恶性纤维组织细胞瘤（3例患者）、间皮瘤（2例患者）、横纹肌肉瘤（1例患者）和原发性淋巴瘤（1例患者）。长期随访数据显示，11名患者中有10名（91%）死亡，从诊断到死亡的平均时间为9.7个月。较新的病理学技术用于鉴别肉瘤，积极的手术切除和某些亚组的先进化疗可能有助于这些肿瘤患者在未来更好的生存。此外，对于局限性心脏病患者，心脏移植也将成为未来的重要治疗手段。
Malignant primary cardiac tumors have uniformly been associated with poor long-term survival. We reviewed data on 11 patients with such tumors seen between 1956 and 1986. There were five men and six women, with a mean age at presentation of 44 years. Nine (82 percent) of 11 patients presented initially with respiratory symptoms, and 45 percent (five) presented with chest pain. No patient was asymptomatic on initial presentation. Forty-five percent (five) of the patients had elevated jugular venus pressure or a systolic murmur. Cardiomegaly was present in eight (73 percent) of 11 patients. Nine of ten patients had a hemoglobin level less than 12 g/100 ml, and 30 percent (3/10) presented with thrombocytosis. Seventy percent (eight) of the patients underwent surgical biopsy, and in 30 percent (three), surgical excision of the tumor was attempted. Angiosarcoma was the most frequent type of tumor (four patients), followed by malignant fibrous histiocytoma (three patients), mesothelioma (two patients), rhabdomyosarcoma (one patient), and primary lymphoma (one patient). Long-term follow-up data reveals that ten (91 percent) of 11 patients had died with a mean duration from diagnosis until death of 9.7 months. Newer pathologic techniques for identification of sarcomas, aggressive surgical resection, and advanced chemotherapy for certain subgroups may contribute to better survival for patients with these tumors in the future. In addition, cardiac transplantation may play an important rule in the future for those patients with localized disease.