摘要
心脏血管瘤是一种非常少见的良性心脏肿瘤,只占原发性心脏肿瘤的2.8%。肿瘤位置的不同导致其临床症状多样化甚至无任何临床症状。由于其罕见性,且临床症状、影像表现、位置等多变,使得诊断较为困难。解剖上讲,血管瘤可以位于心脏任何位置,但仍以室间隔及右心房较为多见。这里介绍两个心脏海绵状血管瘤病例,分别位于房间沟及右房室交界区。两位病人均在我院接受心脏血管瘤切除手术,手术在建立体外循环且心脏停跳下进行。房间沟血管瘤病人术后1年半随访,日常生活无明显症状及阳性体征,心超未发现复发迹象；房室交界区血管瘤病人术后2年随访,日常生活无明显症状及阳性体征,心超未发现复发迹象。
Cardiac hemangioma is an extremely rare benign cardiac tumor and only take over2.8%of primary cardiac tumors. Cardiac hemangioma could lead to various symptoms or show as asymptomatic because of its variable localization. The rarity, the variable of clinical symptom, imaging performance and localization all contribute to the difficulty of making the diagnosis of cardiac hemangioma. Cardiac hemangioma could locate any part of the heart, with predominance of ventricular septum and right atrium. Here we describe two cases of cardiac cavernous hemangioma with the locations of the interatrial groove and right atrioventricular junction, respectively. Both patients accepted cardiac surgery to remove the mass under cardiopulmonary bypass and cardiac arrest. The patient with cardiac hemangioma in interatrial groove remained asymptomatic and had no positive sign one and a half years after surgery. Echocardiography showed no recurrence. The patient with cardiac hemangioma in right atrioventricular junction remained asymptomatic and had no positive sign two years after surgery. Echocardiography showed no recurrence.
引文
[1]Reynen K. Frequency of primary tumors of the heart. Am J Cardiol 1996;77(1):107.
[2]Silber EN. Heart disease,2nd ed. New York:Macmillan,1987. pp.1427-48.
[3]Blondeau P. Primary cardiac tumors--French studies of 533 cases. Thorac Cardiovasc Surg.1990 Aug;38 Suppl 2:192-5.
[4]Elbardissi AW, Dearani JA, Schaff HV. etl. Survival after resection of primary cardiac tumors:a 48-year experience. Circulation.2008 Sep 30;118(14 Suppl):S7-15.
[5]McAllister Jr HA. Primary tumours of the heart and pericardium. Pathol Annu 1979;14:325-55.
[6]Burke A, Johns JP, Virmani R. Hemangiomas of the heart:a clinicopathologic study of ten cases.Am J Cardiovasc Pathol 1990:3:283-90.
[7]Hauh Jr AM. Tumors of heart and pericardium. In:Malcom D, editor. Cardiovascular pathology, New York:Churchill Livingstone Inc,1983.pp.909-943.
[8]Brizard Ch, Latremoulli Ch,Carpentier AF.etal. Cardiac hemangiomas. Ann Thorac Surg1993;56:390-394.
[9]Manasse E, Nicolini F,Gallotti R.et al. Left ventricular hemangioma. Eur J Cardiothorac Surg 1999;15(6):864-6.
[10]Grevenc ML, Rosado de Christenson ML, Galvin JR.et al. Primary cardiac and pericardial neoplasma:radiologic pathologic correlation. Radiographics 2000;20:1073-103.
[11]Kipfer B, Englberger L, Stauffer E, Carrel T (2000) Rare presentation of cardiac hemangiomas. Ann Thorac Surg 70:977-979.
[12]Scully RE, Mark EJ, Phillips LD.et al. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 20-1997. A 74-year-old man with progressive cough, dyspnea, and pleural thickening. N Engl J Med 1997;336(June (26)):1895-903.
[13]Yuasa U, Watanabe F, Shomura S. et al. Resection of a metastatic left ventricular tumor with an aid of thoracoscopy. Kyobu Geka.2011 Jul;64(7):558-60.
[1]Simpson L, Kumar SK, Moynihan TJ, et al. Malignant primary cardiac tumors: review of a single institution experience. Cancer 2008; 112(11):2440-2446.
[2]Reynen K. Frequency of primary tumors of the heart. Am J Cardiol 1996;77(1): 107.
[3]Reardon MJ, Walkes JC, Benjamin R. Therapy insight:malignant primary cardiac tumors. Nat Clin Pract Cardiovasc Med 2006;3(10):548-553.
[4]Bussani R, De-Giorgio F, Silvestri F, et al. Cardiac metastases. J Clin Pathol 2007;60(1):27-34.
[5]Blondeau P. Primary cardiac tumors--French studies of 533 cases. Thorac Cardiovasc Surg.1990 Aug;38 Suppl 2:192-5.
[6]Elbardissi AW, Dearani JA, Schaff HV. et al. Survival after resection of primary cardiac tumors:a 48-year experience. Circulation 2008;118(14 Suppl):S7-15.
[7]Robbins SL, Cotran RS. Pathologic basis of disease.2nd ed. Philadelphia: Saunders.1981:635.
[8]Kim EY, Choe YH. Ko YH. et al.Multidetector CT and MR Imaging of Cardiac Tumors.Korean J Radiol.2009 Mar-Apr; 10(2):164-75.
[9]Brizard Ch, Latremoulli Ch, Carpentier AF.et al. Cardiac hemangiomas. Ann Thorac Surg 1993;56:390-394.
[10]Burke A, Johns JP, Virmani R. Hemangiomas of the heart:a clinicopathologic study of ten cases. Am J Cardiovasc Pathol 1990;3:283-90.
[11]Hauh Jr AM. Tumors of heart and pericardium. In:Malcom D, editor.Cardiovascular pathology, New York:Churchill Livingstone Inc,1983.pp. 909-943.
[12]Silber EN. Heart disease,2nd ed. New York:Macmillan,1987. pp.1427-48.
[13]De Filippo M, Corradi D, Zompatori M. Et al. Hemangioma of the right atrium: imaging and pathology. Cardiovasc Pathol.2010 Mar-Apr;19(2):121-4.
[14]Hong C, Becker CR, Huber A, Schoepf UJ, Ohnesorge B, Knez A, et al. ECG-gated reconstructed multi-detector row CT coronary angiography:effect of varying trigger delay on image quality. Radiology 2001;220:712-717.
[15]Massimo De Filippo, Domenico Corradi, and Maurizio Zompatori,etl.Hemangioma of the right atrium:imaging and pathology. Cardiovascular Pathology 19(2010)121-124.
[16]Newell JD 2nd, Eckel C, Davis M, Tadros NB. MR appearance of an arteriovenous hemangioma of the interventricular septum. Cardiovasc Intervent Radiol 1988;11:319-321.
[17]Sparrow PJ, Kurian JB, Jones TR, Sivananthan MU. MR imaging of cardiac tumors. Radiographics 2005;25:1255-1276.
[18]Gaudio C, Di Michele S, Cera M, Nguyen BL, Pannarale G, Alessandri N. Prominent crista terminalis mimicking a right atrial mixoma:cardiac magnetic resonance aspects. Eur Rev Med Pharmacol Sci 2004;8:165-168.
[19]Paydarfar D, Krieger D, Dib N, Blair RH, Pastore JO, Stetz JJ Jr, et al. In vivo magnetic resonance imaging and surgical histopathology of intracardiac masses: distinct features of subacute thrombi. Cardiology 2001;95:40-47.
[20]Palmer TE, Tresch DD, Bonchek LI (1986) Spontaneous resolution of a large cavernous hemangioma of the heart. Am J Cardiol 58:184-185.
[21]Kipfer B, Englberger L, Stauffer E, Carrel T (2000) Rare presentation of cardiac hemangiomas. Ann Thorac Surg 70:977-979.
[22]Scully RE, Mark EJ, McNeely WF, Ebeling SH, Phillips LD. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 20-1997. A 74-year-old man with progressive cough, dyspnea, and pleural thickening. N Engl J Med 1997;336(June (26)):1895-903.