2005 年的一些关于心包转移的文章:
看得有点难过了。难道外婆就这样临近终点了吗
Primary cardiac tumors are rare. However, when they are found and diagnosed, most cases are known to be histologically benign, with the most common tumor type in all age groups being myxoma5). In the heart, metastatic tumors are many times more common than the primary tumors5). As the overall survival of patients having various malignant tumors is prolonged by more effective therapy, it seems that the frequency of cardiac metastases has also increased4, 5). Tumors with a high tendency of metastasis to the heart are malignant melanoma, leukemia, lymphoma and malignant germ cell tumors3, 6). In absolute numbers, however, the most common primary tumors of cardiac metastases are carcinoma of the lung and breast, and this reflects the high incidence of these malignancies3, 7). Tumor cells reach the heart and pericardium by one of four pathways: retrograde lymphatic extension, hematogenous spread, direct contiguous extension or transvenous extension.
A standard treatment modality for cardiac metastases has not yet been established. Because most patients with cardiac metastases have disseminated disease, the therapy generally consists of treatment for the primary tumor or palliative care. Despite the poor prognosis for patients with cardiac metastasis, however, surgical treatment should be considered when important symptoms of obstruction outweigh the mortality risk of operating and the benefit of medical therapy alone. Especially for the isolated intracardiac tumor with no evidence of widespread disease, surgical resection seems to be safe and relieve the symptoms, and it would very likely prolong the life span of the patient16). For our patient, we initially made a choice of palliative chemotherapy in consideration of the absence of obstructive symptoms and the patient's preference. |