左心房多发滑膜肉瘤1例

Multiple synovial sarcoma of left atrium: a case report

目的探讨左心房多发滑膜肉瘤患者的临床特点和治疗方法。方法回顾性分析1例左心房多发滑膜肉瘤患者的临床资料。结果活动后出现胸闷、气促伴腹泻4 d为急诊就诊症状,以“急性左心衰竭”入院,心脏彩超示左心房多发实质性占位病变,阻塞二尖瓣口致二尖瓣重度狭窄;增强胸部电子计算机断层扫描(CT)显示肿物轻度均匀强化,经多学科会诊讨论后,行手术切除肿瘤及累及的二尖瓣,植入一枚人工生物二尖瓣;术后病理诊断心脏滑膜肉瘤。结论原发性心脏滑膜肉瘤临床上较为罕见,临床表现复杂多样,在无远处转移的情况下,手术切除肿瘤为治疗首选。

Objective To explore the clinical features and treatment method of multiple synovial sarcoma in left atrium.Methods The clinical data of a patient with multiple synovial sarcoma in left atrium were analyzed retrospectively.Results With chest tightness and shortness of breath after the exercise combined with diarrhea for four days as the symptoms at first visit,the patient was admitted with"acute left heart failure".Echocardiography showed multiple solid space-occupying lesions in the left atrium,which blocked the mitral valve orifice and then caused severe mitral stenosis.Enhanced computed tomography(CT)of the chest showed mild homogeneous enhancement of the mass.After discussion by multi-disciplinary consultation,the tumor and the involved mitral valve were surgically removed and an artificial mitral valve was implanted.Cardiac synovial sarcoma was diagnosed by postoperative pathology.Conclusion Primary cardiac synovial sarcoma is rare in clinic and has complicated clinical manifestations.In the absence of distant metastasis,surgical resection of the tumor is the first choice for treatment.