肺动脉肉瘤广泛侵犯右心室:病例报告和治疗方案回顾。

Alev Gumus, Alain De Caevel, Bogdan F Trifan
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引用次数: 0

摘要

肺动脉肉瘤(PAS)是一种罕见的侵袭性癌症,起源于肺动脉(PA)内膜层,常被误诊为肺血栓栓塞症。本病例报告强调了肺动脉肉瘤治疗的复杂性,以及多学科方法对准确诊断和治疗的必要性。一名 52 岁的女性患者通过影像学和治疗检查确诊了 PAS,并将其与肺栓塞区分开来。主要治疗包括手术切除肺动脉干、瓣膜和肿瘤,然后进行重建。由于右心室心内膜广泛浸润,无法进行完全切除,因此无法进行心脏移植。患者接受了辅助放疗,但疾病复发,确诊后 3 年去世。本病例强调了右心室广泛浸润的罕见性、缺乏明确的 PAS 管理指南以及辅助疗法有效性的证据有限。报告认为,多学科团队对决策至关重要,并强调需要进一步研究以制定有效的治疗方案。
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Pulmonary Artery Sarcoma with Extensive Invasion of the Right Ventricle: A Case Report and Review of Therapeutic Options.

Pulmonary artery sarcoma (PAS) is a rare, aggressive cancer originating from the intimal layer of the pulmonary artery (PA), often mistaken for pulmonary thromboembolism. This case report underscores the complex management of PAS and the necessity of a multidisciplinary approach for accurate diagnosis and treatment. A 52-year-old woman with PAS was diagnosed using imaging and therapeutic tests to distinguish it from pulmonary embolism. Primary treatment included surgical resection of the pulmonary trunk, valve, and tumor, followed by reconstruction. Complete resection was impossible due to extensive endocardial infiltration in the right ventricle, precluding cardiac transplant. The patient underwent adjuvant radiotherapy; however, the disease recurred, and she died 3 years post-diagnosis. This case highlights the rarity of an extensive right ventricle invasion, the absence of clear PAS management guidelines, and the limited evidence on the effectiveness of adjuvant therapies. It concludes that multidisciplinary teams are vital for decision-making and stresses the need for further research to establish effective treatment protocols.

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