Diagnosis and Surgical Treatment of Malignant Cardiac Tumors_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIUKai-yu ,  TIANHai , JIANGShu-lin

Department of Cardiovascular Surgery, Second Affiliated Hospital, Harbin Medical University, Harbin 150086, P. R. China;

Corresponding author：

TIANHai, Email: clownemail@163.com

Keywords：

Malignant cardiac tumor; Diagnosis; Surgery

DOI：

10.7507/1007-4848.20140131

Video：

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Objective To investigate clinical characteristics of patients with malignant cardiac tumors, and summarize our diagnostic methods and surgical treatment experience. Methods Clinical data of 16 patients with mali-gnant cardiac tumors who were admitted to Department of Cardiovascular Surgery, Second Affiliated Hospital of Harbin Medical University between January 2005 and February 2012 were retrospectively analyzed. There were 8 male and 8 female patients with their age of 35-64 (47.8±10.9) years and disease duration of 15 days to 48 months (11.8±10.9) months. Among the 16 patients, 13 patients underwent tumor resection under cardiopulmonary bypass (CPB), including 1 patient who received complete resection of the tumor and pedicle surrounding tissue and other 12 patients who only received partial tumor resection. One patient underwent concomitant tricuspid valve replacement. Results All the operations were performed successfully. One patient died of low cardiac output syndrome and multiple organ dysfunction syndrome on the 6th postoperative day. All the other patients were successfully discharged. Average operation time was 181.2±59.5 minutes, average CPB time was 68.8±20.8 minutes, and average length of hospital stay was 20.4±7.4 days. Postoperative pathological examination showed primary cardiac malignant tumors in 9 patients, metastatic malignant tumors in 6 patients, and benign tumor with malignant growth in 1 patient. Three patients were followed up for a short time (≥3 months) and were still alive. Nine patients died in 1-14 months after discharge. One patient with benign cardiac tumor but malignant growth was still alive. Conclusion Malignant cardiac tumors are rare but highly malignant with a high rate of misdiagnosis. Surgical outcomes are comparatively satisfactory, but these patients' prognosis is usually poor.

Citation： LIUKai-yu, TIANHai, JIANGShu-lin. Diagnosis and Surgical Treatment of Malignant Cardiac Tumors. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(4): 461-464. doi: 10.7507/1007-4848.20140131 Copy

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11.	刘莉, 宋秀珍, 谢德轩.多普勒超声心动图对心脏原发性肿瘤的应用研究.中国医学影像技术, 2008, 24 (6):896-899.
12.	Bauner KU, Sourbron S, Picciolo M, et al. MR first pass perfusion of benign and malignant cardiac tumours-significant differences and diagnostic accuracy. Eur Radiol, 2012, 22 (1):73-82.
13.	李德强, 阎德民, 谷天祥, 等.右房粘液瘤的外科治疗.中国医科大学学报, 2001, 30 (2):156-157.
14.	Qin C, Chen L, Xiao YB, et al. Giant primary leiomyoma of the right ventricle. J Card Surg, 2010, 25 (2):169-1671.
15.	Karasu BB, Yeter E, Yilmazer D, et al. Primary valvular lipomatous hamartoma:a case report and a collective review of the literature. Cardiovasc Pathol, 2011, 20 (6):377-380.
16.	Yuan SM, Shinfeld A, Raanani E. Tricuspid valve myxoma:a case report and a collective review of the literature. J Card Surg, 2009, 24 (1):69-72.
17.	高志, 路天怡, 许建屏, 等.心脏恶性肿痛10例分析.北京大学学报:医学版, 2003, 35 (3):333-334.
18.	张勇, 梁家立.心脏原发恶性肿瘤五例报告.中华肿瘤防治杂志, 2012, 19 (22):1751-1752.
19.	张玉海, 谷天祥, 王春, 等.累及心脏的静脉内平滑肌瘤的诊断策略和外科治疗.中国医科大学学报, 2012, 41 (12):1148-1149.
20.	李旻, 潘凌亚, 连丽娟.伴有心脏受累的静脉内平滑肌瘤病临床分析.现代妇产科进展, 2006, 15 (3):191-194.

1. 王咏, 肖颖彬, 陈林, 等.心脏肿瘤181例外科治疗的临床分析.中国胸心血管外科临床杂志, 2013, 20 (2):155-158.
2. 朱云喜, 胡建国, 周新民, 等.原发性心脏肿瘤138例的临床诊断与外科治疗.肿瘤, 2010, 30 (11):965-968.
3. Miyake CY, Del Nido PJ, Alexander ME, et al. Cardiac tumors and associated arrhythmias in pediatric patients, with observations on surgical therapy for ventricular tachycardia. J Am Coll Cardio, 2011, 58 (18):1903-1909.
4. Combes M, Rottey S, De Backer T. Cardiovascular toxicity of cancer treatment. Acta Clin Belg, 2011, 66 (4):260-266.
5. 宋书田, 周岊梧, 张彬, 等.原发性心脏恶性肿瘤的诊断与外科治疗经验.中国心血管杂志, 2008, 13 (4):268-270.
6. Debourdeau P, Gligorov J, Teixeira L, et al. Malignant cardiac tumors. Bull Cancer, 2004, 91 (Suppl 3):136-146.
7. Gopal AS, Stathopoulos JA, Arora N, et al. Differential diagnosis of intracavitary tumors obstructing the right ventricular outflow tract. J Am Soc Echocardiogr, 2001, 14 (9):937-940.
8. Kubota H, Takamoto S, Kotsuka Y, et al. Surgical treatment of malignant tumours of the right heart. Jpn Heart J, 2002, 43 (3):263-271.
9. 邓明彬, 廖斌, 李新, 等. 22例心脏肿瘤的诊断与治疗.中国胸心血管外科临床杂志, 2011, 18 (2):108.
10. 谢宝栋, 康凯, 张宇南, 等. 28例右心系统肿瘤的诊断与外科治疗.中国胸心血管外科临床杂志, 2007, 14 (4):306-307.
11. 刘莉, 宋秀珍, 谢德轩.多普勒超声心动图对心脏原发性肿瘤的应用研究.中国医学影像技术, 2008, 24 (6):896-899.
12. Bauner KU, Sourbron S, Picciolo M, et al. MR first pass perfusion of benign and malignant cardiac tumours-significant differences and diagnostic accuracy. Eur Radiol, 2012, 22 (1):73-82.
13. 李德强, 阎德民, 谷天祥, 等.右房粘液瘤的外科治疗.中国医科大学学报, 2001, 30 (2):156-157.
14. Qin C, Chen L, Xiao YB, et al. Giant primary leiomyoma of the right ventricle. J Card Surg, 2010, 25 (2):169-1671.
15. Karasu BB, Yeter E, Yilmazer D, et al. Primary valvular lipomatous hamartoma:a case report and a collective review of the literature. Cardiovasc Pathol, 2011, 20 (6):377-380.
16. Yuan SM, Shinfeld A, Raanani E. Tricuspid valve myxoma:a case report and a collective review of the literature. J Card Surg, 2009, 24 (1):69-72.
17. 高志, 路天怡, 许建屏, 等.心脏恶性肿痛10例分析.北京大学学报:医学版, 2003, 35 (3):333-334.
18. 张勇, 梁家立.心脏原发恶性肿瘤五例报告.中华肿瘤防治杂志, 2012, 19 (22):1751-1752.
19. 张玉海, 谷天祥, 王春, 等.累及心脏的静脉内平滑肌瘤的诊断策略和外科治疗.中国医科大学学报, 2012, 41 (12):1148-1149.
20. 李旻, 潘凌亚, 连丽娟.伴有心脏受累的静脉内平滑肌瘤病临床分析.现代妇产科进展, 2006, 15 (3):191-194.

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Diagnosis and Surgical Treatment of Malignant Cardiac Tumors

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