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心脏右心房未分化肉瘤1例并文献回顾
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Abstract:
目的：探讨原发性心脏未分化肉瘤的临床症状、影像学检查及病理表现特点。方法：对温州医科大学附属衢州医院收治的1例心脏未分化肉瘤患者的临床资料进行回顾性分析，并以“心脏未分化肉瘤”为关键词，检索中国知网、万方数据库和中华医学期刊全文数据库，以“cardiac undifferentiated sarcoma”为关键词检索PubMed数据库，检索时间自建库至2023年12月，总结原发性心脏未分化肉瘤的临床症状、影像学检查及病理表现特点。结果：检索国内外文献共收集到原发性心脏未分化肉瘤47例，加上本例共48例。原发性心脏未分化肉瘤患者临床表现为进行性呼吸困难、双下肢水肿、乏力、咳嗽咳痰、胸痛。发病部位位于右心房5例，右心室9例，左心房19例，左心室8例，心包2例，未明确3例。最小年龄为1岁，最大发病年龄为87岁，其中50~70岁发病23例。结论：心脏未分化肉瘤患者的临床表现多样，不具有典型性，以进行性呼吸困难最多见；超声心动图对于诊断具有重要意义，最终确诊仍需病理检查。
Objective: To investigate the clinical symptoms, imaging and pathological features of primary car-diac undifferentiated sarcoma. Methods: The clinical data of one patient with cardiac undifferenti-ated sarcoma admitted to Quzhou Hospital Affiliated to Wenzhou Medical University were retro-spectively analyzed. “Cardiac undifferentiated sarcoma” was used as the key word to search China National Knowledge Infrastructure (CNKI), Wanfang Database and Chinese Medical Journal Full-text Database. “Cardiac undifferentiated sarcoma” was used as the key word to search PubMed database. The search time was from the establishment of the database to December 2023. The clinical symp-toms, imaging examination and pathological features of primary cardiac undifferentiated sarcoma were summarized. Results: A total of 47 cases of primary cardiac undifferentiated sarcoma were collected from domestic and foreign literatures; including this example, there are a total of 48 cases. The clinical manifestations of patients with primary cardiac undifferentiated sarcoma were pro-gressive dyspnea, edema of both lower limbs, fatigue, cough and expectoration, and chest pain. The location of the disease was located in the right atrium in 5 cases, right ventricle in 9 cases, left atrium in 19 cases, left ventricle in 8 cases, pericardium in 2 cases, and unclear in 3 cases. The minimum age was 1 year old, and the maximum age of onset was 87 years old, including 23 cases of 50~70 years old. Conclusions: The clinical manifestations of patients with cardiac undifferentiated sarcoma are diverse and not typical. Progressive dyspnea was the most common symptom; echo-cardiography is of great significance for diagnosis, and final diagnosis still requires pathological examination.
| [1] | Kerbl, D., Exposito, J., Carabello, J., et al. (2023) An Undifferentiated, Pleomorphic Cardiac Sarcoma Masquerading as Myxoma. Journal of Cardiology Cases, 27, 41-45. https://doi.org/10.1016/j.jccase.2022.09.013 |
| [2] | 孟嫦娟, 张鸿瑞, 张建刚, 等. 心脏原发性未分化多形性肉瘤临床病理观察[J]. 诊断病理学杂志, 2014, 21(11): 693-695. |
| [3] | Prakash, S., Luis Rayas, J., Rojas Murguia, A., et al. (2022) Undifferentiated Pleomorphic Sarcoma Pre-senting with Cardiac Tamponade: A Case Report and Review. Journal of Investigative Medicine High Impact Case Re-ports, 10, 1-6.
https://doi.org/10.1177/23247096221141190 |
| [4] | Abbas, H.A., Amini, B., Wang, W.L., et al. (2020) Maneuvering the Management of a Rare Case of Primary Undifferentiated Cardiac Sarcoma. The American Journal of Case Reports, 21, e918878.
https://doi.org/10.12659/AJCR.918878 |
| [5] | Akutsu, H., Saito, S., Muraoka, A., et al. (2023) Primary Cardiac Un-differentiated Pleomorphic Sarcoma in the Left Atrium: Report of a Case. Kyobu Geka: The Japanese Journal of Thorac-ic Surgery, 76, 966-969. |
| [6] | Alam, L., Agrawal, K., Kankanala, V., et al. (2020) Primary Cardiac Undifferentiated High-Grade Intimal Pleomorphic Sarcoma: A Case Series Report. Cardiology Research, 11, 129-133. https://doi.org/10.14740/cr1029 |
| [7] | Beneki, E., Zachos, P. and Tsatiris, K. (2023) Primary Cardiac Undifferenti-ated Pleomorphic Sarcoma. Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiol-ogy, 42, 281-282.
https://doi.org/10.1016/j.repc.2021.08.013 |
| [8] | Di Buono, G., Randisi, B., Romano, G., et al. (2020) Recurrent Intussusception of Small Bowel in a Young Patient due to Metastases from Cardiac Undifferentiated Pleomorphic Sar-coma: A First Ever Case Report. International Journal of Surgery Case Reports, 77, S13-S16. https://doi.org/10.1016/j.ijscr.2020.09.065 |
| [9] | Escárcega, R.O., Bailey, D. and Defrain, M.P. (2022) Multimodal-ity Imaging for the Evaluation of an Undifferentiated Pleomorphic Sarcoma Presenting as Cardioembolic Stroke. Case Reports in Cardiology, 2022, Article ID: 2749303.
https://doi.org/10.1155/2022/2749303 |
| [10] | Espinoza-Cobos, J.C., Ortiz-Obregón, S., Blanco-Lemus, E., et al. (2021) High-Grade Undifferentiated Pleomorphic Cardiac Sarcoma: A Rare Malignant Primary Cardiac Tumor Mimick-ing Double Mitral Lesion. Archivos de Cardiologia de Mexico, 91, 388-390. https://doi.org/10.24875/ACME.M21000242 |
| [11] | Fomin, V.V., Kogan, E.A., Chichkova, N.V., et al. (2018) Un-differentiated Sarcoma of the Pericardium after Radiation Therapy for Hodgkin’s Lymphoma. Terapevticheskii Arkhiv, 90, 69-73. https://doi.org/10.26442/terarkh201890869-73 |
| [12] | Furukawa, H., Honda, T., Yamasawa, T., et al. (2020) Surgical Management of Large Undifferentiated Cardiac Sarcoma Involving the Right Ventricle to Pulmonary Trunk. General Thoracic and Cardiovascular Surgery, 68, 1031-1036.
https://doi.org/10.1007/s11748-019-01208-1 |
| [13] | Glybochko, P.V., Fomin, V.V., Chichkova, N.V., et al. (2020) Primary Undifferentiated Pericardial Sarcoma after RadiоTherapy for Hodgkin Lymphoma. Case Reports in Oncology, 13, 1075-1081. https://doi.org/10.1159/000510068 |
| [14] | Ha, F.J., Dimitriou, J. and Huang, A.L. (2023) A Rare Case of Left Atrial Undifferentiated Pleomorphic Sarcoma. European Heart Journal Case Reports, 7, Ytad481. https://doi.org/10.1093/ehjcr/ytad481 |
| [15] | Hirata, R., Tago, M., Hisata, Y., et al. (2020) Primary Cardiac Undif-ferentiated Pleomorphic Sarcoma: An Alarming Cause of Lower Back Pain. BMJ Case Reports, 13, e235168. https://doi.org/10.1136/bcr-2020-235168 |
| [16] | Karasudani, R., Nakanishi, N., Tabata, M., et al. (2023) Huge Pri-mary Cardiac Undifferentiated Pleomorphic Sarcoma. Internal Medicine (Tokyo, Japan). https://doi.org/10.2169/internalmedicine.2733-23 |
| [17] | Kwon, J. and Kwon, K. (2020) Primary Undifferentiated Spindle Cell Sarcoma Obstructing the Right Ventricular Outflow Tract. Journal of Cardiothoracic Surgery, 15, Article No. 71. https://doi.org/10.1186/s13019-020-01129-8 |
| [18] | Lo Piccolo, F., Santer, D., Schulze, E., et al. (2023) Un-differentiated Cardiac Sarcoma of the Mitral Valve: Multimodal Imaging Assessment. Radiology Cardiothoracic Imaging, 5, e220291. https://doi.org/10.1148/ryct.220291 |
| [19] | Mladenovic, Z., Obradovic, S., Ristic, S., et al. (2023) A Rare Case of Undifferentiated Pleomorphic Sarcoma with Central Necrosis in the Right Atrium. Turk Kardiyoloji Dernegi Ar-sivi: Turk Kardiyoloji Derneginin Yayin Organidir, 51, 155-158. https://doi.org/10.5543/tkda.2022.97918 |
| [20] | Picón-Jaimes, Y.A., Ortega-Uribe, L.F., Orozco-Chinome, J.E., et al. (2020) Primary Undifferentiated Sarcoma of Left Atrium. Cirugia Y Cirujanos, 88, 98-101. https://doi.org/10.24875/CIRU.20001718 |
| [21] | Reyes-Robledo, G.B., Andrade-Cuellar, E.N., Elizalde Uribe, I.A., et al. (2023) Left Atrial Undifferentiated Pleomorphic Sarcoma Causing Left Ventricular Inflow Tract Obstruction: A Case Report. European Heart Journal Case Reports, 7, Ytad560. https://doi.org/10.1093/ehjcr/ytad560 |
| [22] | Sia, C.H., Goh, F.Q., Kong, W.K., et al. (2020) Cardiac Sarcoma Attached to Pacemaker Lead. Journal of Cardiac Surgery, 35, 1148-1151. https://doi.org/10.1111/jocs.14541 |
| [23] | Stoica, A.I., Harpa, M.M., Banceu, C.M., et al. (2022) A Rare Case of Undifferentiated Pleomorphic Cardiac Sarcoma with Inflammatory Pattern. Medicina (Kaunas, Lithuania), 58, Article No. 1009.
https://doi.org/10.3390/medicina58081009 |
| [24] | Tan, S.F., Abbas, S.O.A., Mayooran, N., et al. (2023) Primary Undifferentiated High-Grade Pleomorphic Cardiac Sarcoma in the Left Atrium with Atypical Presentation. BMJ Case Reports, 16, e252198.
https://doi.org/10.1136/bcr-2022-252198 |
| [25] | Tsai, A.K., Vyfhuis, M.A.L., Francis, M., et al. (2018) Radia-tion-Induced Undifferentiated Pleomorphic Sarcoma of the Heart: A Case Report. Practical Radiation Oncology, 8, 136-139. https://doi.org/10.1016/j.prro.2017.10.010 |
| [26] | Ugarte, S., Sandhu, R.S., Sung, J., et al. (2021) Primary Undifferentiated Pleomorphic Cardiac Sarcoma Presenting as Right Heart Failure. Radiology Case Reports, 16, 829-834. https://doi.org/10.1016/j.radcr.2021.01.016 |
| [27] | Vaitiekiene, A., Vaitiekus, D., Urbonaite, L., et al. (2019) Multi-disciplinary Approach to Rare Primary Cardiac Sarcoma: A Case Report and Review. BMC Cancer, 19, Article No. 529. https://doi.org/10.1186/s12885-019-5705-2 |
| [28] | Vallés-Torres, J., Izquierdo-Villarroya, M.B., Vallejo-Gil, J.M., et al. (2019) Cardiac Undifferentiated Pleomorphic Sarcoma Mimicking Left Atrial Myxoma. Journal of Cardiothoracic and Vascular Anesthesia, 33, 493-496.
https://doi.org/10.1053/j.jvca.2018.02.010 |
| [29] | Verbeek, S., Sciot, R., Debiec-Rychter, M., et al. (2023) Case Re-port: Cardiac Intimal Sarcoma in a Young Child. Frontiers in Pediatrics, 11, Article ID: 1238847. https://doi.org/10.3389/fped.2023.1238847 |
| [30] | Wang, R., Shen, G. and Tian, R. (2020) Primary Atrial Undiffer-entiated Sarcoma Found on FDG PET/CT Mimicking Cardiac Myxoma. Clinical Nuclear Medicine, 45, 833-835. https://doi.org/10.1097/RLU.0000000000003236 |
| [31] | Watson, R., Frye, J., Trieu, M., et al. (2018) Primary Un-differentiated Pleomorphic Cardiac Sarcoma with MDM2 Amplification Presenting as Acute Left-Sided Heart Failure. BMJ Case Reports, 2018.
https://doi.org/10.1136/bcr-2018-226073 |
| [32] | Yadsar, S., Abavisani, M., Lakziyan, R., et al. (2021) Right Ventric-ular Undifferentiated Pleomorphic Sarcoma: A Case Report. Annals of Cardiac Anaesthesia, 24, 102-104. https://doi.org/10.4103/aca.ACA_53_19 |
| [33] | Yoshida, M., Seo, M., Watanabe, T., et al. (2023) A Case of Cardiac Undifferentiated Pleomorphic Sarcoma with Right Ventricular Outflow Tract Obstruction. International Heart Journal, 64, 779-782.
https://doi.org/10.1536/ihj.23-037 |
| [34] | Yue, P., Chen, Z., Xu, Z., et al. (2022) Undifferentiated Cardiac Sarcoma on the Mitral Valve Mimicking Myxoma. Circulation Journal: Official Journal of the Japanese Circulation Society, 86, 335.
https://doi.org/10.1253/circj.CJ-21-0689 |
| [35] | Zhang, M., Yang, Y., Guan, X., et al. (2021) Primary Cardiac CIC-Rearranged Undifferentiated Sarcoma in an Infant. Pediatric Investigation, 5, 313-317. https://doi.org/10.1002/ped4.12264 |
| [36] | 程楠, 高建英, 孔钰. 心脏未分化肉瘤伴全身多发转移~(18)F-FDG PET/CT显像1例[J]. 医学影像学杂志, 2020, 30(7): 1334-1335. |
| [37] | 樊纪丹, 安君, 王巍. 原发性心脏未分化多形性肉瘤一例[J]. 中国胸心血管外科临床杂志, 2012, 19(5): 580. |
| [38] | 郭长升. 心脏右心室未分化肉瘤1例[J]. 第三军医大学学报, 2011, 33(13): 1357+1361. |
| [39] | 韩博, 薛彤霄, 何滨, 等. 心脏未分化肉瘤一例[J]. 临床放射学杂志, 2008(11): 1505. |
| [40] | 李溢煊, 连锦英. 心脏原发性未分化肉瘤一例[J]. 中华内科杂志, 1989, 28(8): 494, C13. |
| [41] | 刘博, 李尚俭, 官功昌, 等. 原发心脏未分化多形性肉瘤并肺脏多发转移一例[J]. 中国循环杂志, 2014, 29(12): 963. |
| [42] | 钱松屹, 王凤林, 刘鹏, 等. 心脏右室流出道未分化肉瘤1例[J]. 中华胸心血管外科杂志, 2005(2): 93. |
| [43] | 史玉洁, 孙续鹏, 李雄峰, 等. 心脏/肺动脉未分化(内膜)肉瘤中MDM2的表达及临床病理分析[J]. 临床与实验病理学杂志, 2020, 36(7): 807-811. |
| [44] | 余松华, 段冰松, 张桂敏. 左心房未分化肉瘤一例[J]. 中国循环杂志, 2016, 31(Z1): 80. |
| [45] | Matebele, M.P., Peters, P., Mundy, J., et al. (2010) Cardiac Tumors in Adults: Surgical Management and Follow-Up of 19 Patients in an Australian Tertiary Hospital. Interactive Cardiovascular and Thoracic Surgery, 10, 892-895.
https://doi.org/10.1510/icvts.2009.230029 |
| [46] | 谢记文, 杨晓娟, 谢静, 等. 原发性心脏平滑肌肉瘤1例及超声心动图误诊分析[J]. 中国社区医师(医学专业), 2012, 14(8): 281-282. |
| [47] | 刘倩倩, 蔡瑶瑶, 万琳媛, 等. 右心房肿物的临床及超声心动图特征、病理及随访分析[J]. 中国分子心脏病学杂志, 2023, 23(5): 5606-5611. |
| [48] | Ma, H., Niu, Y., Tian, M., et al. (2022) A Study of 399 Cardiac Tumors: Characteristics of Echocardiography and Pathological Features. Echocardiography (Mount Kisco, NY), 39, 37-45. https://doi.org/10.1111/echo.15249 |
| [49] | 李岩, 王清国, 王丽园, 等. 多模态影像学诊断心脏占位性病变[J]. 中国介入影像与治疗学, 2023, 20(12): 745-748. |
| [50] | Winther, C., Timmermans-Wielenga, V., Daugaard, S., et al. (2011) Primary Cardiac Tumors: A Clinicopathologic Evaluation of Four Cases. Cardiovascular Pathology: The Official Journal of the Society for Cardiovascular Pathology, 20, 63-67. https://doi.org/10.1016/j.carpath.2009.11.004 |
