Options
右心房內轉移性骨膜囊內瘤
Journal Volume
中山醫學雜誌 v14 n.1 p159-163
Date Issued
2010-07-28T08:57:00Z
Abstract
滑膜囊內瘤合併心臟內轉移，甚少發生，尤其是兒童更是少見，手術移除右心房內滑膜囊內瘤應特別注意上下腔靜脈的侵犯，出血的控制，避免瘤腫的栓塞及完全的切除。我們報告一位12歲男孩因右肩鎖骨滑膜囊內瘤轉移至右心房，形成上腔靜脈症候群，腫瘤完全堵住三尖瓣入口，造成發紺、氣促、心臟超音波及磁振攝影，均可看到一完整的瘤腫佔住上腔靜脈及三尖瓣入口。此男孩經過成功的摘除手術，半年內心臟功能由第四級恢復到第一級，成果佳。
Synovial sarcoma metastatic to the heart is rare. We report a case of synovial sarcoma metastatic to the right atrium in a 12-year-old boy who presented with signs and symptoms of superior vena cava obstruction. Echocardiography and magnetic resonance imaging (MRI) demonstrated a large, mobile intraluminal mass extending from the superior vena cava into the right atrium and obstructing the tricuspid orifice during diastole. Because of worsening clinical condition, surgery was performed and a well-encapsulated right atrial tumor was excised. Signs and symptoms of caval obstruction rapidly resolved. Six months after surgery, patient's New York Heart Association (NYHA) functional classification had improved from Class VI to Class I.
Synovial sarcoma metastatic to the heart is rare. We report a case of synovial sarcoma metastatic to the right atrium in a 12-year-old boy who presented with signs and symptoms of superior vena cava obstruction. Echocardiography and magnetic resonance imaging (MRI) demonstrated a large, mobile intraluminal mass extending from the superior vena cava into the right atrium and obstructing the tricuspid orifice during diastole. Because of worsening clinical condition, surgery was performed and a well-encapsulated right atrial tumor was excised. Signs and symptoms of caval obstruction rapidly resolved. Six months after surgery, patient's New York Heart Association (NYHA) functional classification had improved from Class VI to Class I.