心脏原发性肿瘤61例临床病理分析

Cardiac primary tumors: a clinicopathological analysis of 61 cases

目的探讨心脏原发性肿瘤的临床表现及组织病理学特征。方法回顾性分析中国医学科学院阜外医院深圳医院6年中手术切除61例心脏原发性肿瘤患者的临床及病理资料,并复习相关文献。结果 61例中良性肿瘤57例(93.4%)、恶性肿瘤3例(4.9%)、中间型肿瘤1例(1.6%)。良性者黏液瘤52例(包括感染性黏液瘤1例)、血管瘤4例、乳头状纤维弹力瘤1例;恶性肿瘤均为肉瘤,未分化多形性肉瘤(UPS) 2例、黏液纤维肉瘤1例;中间型者为炎性肌纤维母细胞瘤(IMT)。所有患者均接受了手术治疗,但部分为姑息性手术。部分切除的血管瘤1例随访至今未复发,1例失访;UPS 1例8个月后复发死亡,1例随访1个月状态良好,随后失访;黏液纤维肉瘤一年后复发转移死亡;IMT随访15个月未见复发。恶性者易复发和转移。结论心脏原发性肿瘤罕见,以黏液瘤最多,恶性者以肉瘤为主。临床及影像学表现无特异性,确诊依靠病理学检查。

Objective To investigate the clinical features and histopathological characteristics of cardiac primary tumors.Methods The clinical and pathological data of 61 cases of primary cardiac tumors,which were resected in Fuwai Hospital of Chinese Academy of Medical Sciences, Shenzhen were analyzed retrospectively with review of relevant literatures.Results Among the 61 cases,57 were benign tumors(93.4%),3 were malignant tumors(4.9%) and 1 was intermediate tumor.The benign tumors consisted of myxoma(n = 52),including one case of infectious myxoma,hemangiomas(n = 4),and papillary fibroelastoma(n = 1).The malignant tumors included undifferentiated pleomorphic sarcomas(UPS,n = 2) and myxofibrosarcoma(n = 1).The intermediate tumor was inflammatory myofibroblastoma(IMT).All patients underwent surgical treatment,but some did palliative surgery.One case of partially resected hemangioma had not recurred so far after follow-up,and one case was lost to follow-up.One case of UPS relapsed and died after 8 months;one case was followed up for 1 month in good condition and then lost to follow-up.IMT did not relapse after 15 months of follow-up.Malignant tumors were prone to relapse and metastasis.Conclusion Primary cardiac tumors are rare.Myxoma is the most common type.Malignant tumors are mainly sarcomas.The clinical manifestations and imaging findings are nonspecific,and the diagnosis depends on pathological examination.