PDF(Pubmed)
Abstract：
BACKGROUND: The incidental detection of a right atrial mass during routine cardioncological workup is a rare condition. The correct differential diagnosis between cancer and thrombi is challenging. A biopsy may not be feasible while diagnostic techniques and tools may not be available.
METHODS: We report the case of a 59-year-old female patient with a history of breast cancer and current secondary metastatic pancreatic cancer. She developed deep vein thrombosis and pulmonary embolism and was admitted to the Outpatient Clinic of our Cardio-Oncology Unit for follow-up. Transthoracic echocardiogram incidentally found a right atrial mass. Clinical management was difficult due to the abrupt worsening of the patient\'s clinical condition and the progressive severe thrombocytopenia. We suspected a thrombus, according to its echocardiographic appearance, the patient\'s cancer history and recent venous thromboembolism. The patient was unable to adhere to low molecular weight heparin treatment. Due to worsening prognosis, palliative care was recommended. We also highlighted the distinguishing features between thrombi and tumors. We proposed a diagnostic flowchart to aid diagnostic decision making in the case of an incidental atrial mass.
CONCLUSIONS: This case report highlights the importance of cardioncological surveillance during anticancer treatments to detect cardiac masses.
METHODS: We report the case of a 59-year-old female patient with a history of breast cancer and current secondary metastatic pancreatic cancer. She developed deep vein thrombosis and pulmonary embolism and was admitted to the Outpatient Clinic of our Cardio-Oncology Unit for follow-up. Transthoracic echocardiogram incidentally found a right atrial mass. Clinical management was difficult due to the abrupt worsening of the patient\'s clinical condition and the progressive severe thrombocytopenia. We suspected a thrombus, according to its echocardiographic appearance, the patient\'s cancer history and recent venous thromboembolism. The patient was unable to adhere to low molecular weight heparin treatment. Due to worsening prognosis, palliative care was recommended. We also highlighted the distinguishing features between thrombi and tumors. We proposed a diagnostic flowchart to aid diagnostic decision making in the case of an incidental atrial mass.
CONCLUSIONS: This case report highlights the importance of cardioncological surveillance during anticancer treatments to detect cardiac masses.
摘要：
背景：在常规心脏肿瘤检查中偶然发现右心房肿块是一种罕见的情况。癌症和血栓之间的正确鉴别诊断具有挑战性。活检可能不可行，而诊断技术和工具可能不可用。
方法：我们报告一例59岁女性患者，有乳腺癌和目前的继发性转移性胰腺癌病史。她出现了深静脉血栓形成和肺栓塞，并被送往我们心血管肿瘤科的门诊进行随访。经胸超声心动图偶然发现右心房肿块。由于患者的临床状况突然恶化和进行性严重血小板减少症，临床治疗困难。我们怀疑有血栓,根据其超声心动图外观,患者的癌症病史和近期静脉血栓栓塞症。患者无法坚持低分子量肝素治疗。由于预后恶化，建议姑息治疗。我们还强调了血栓和肿瘤之间的区别特征。我们提出了诊断流程图，以帮助在偶然发生心房肿块的情况下做出诊断决策。
结论：本病例报告强调了在抗癌治疗期间进行心脏肿瘤监测以检测心脏肿块的重要性。
方法：我们报告一例59岁女性患者，有乳腺癌和目前的继发性转移性胰腺癌病史。她出现了深静脉血栓形成和肺栓塞，并被送往我们心血管肿瘤科的门诊进行随访。经胸超声心动图偶然发现右心房肿块。由于患者的临床状况突然恶化和进行性严重血小板减少症，临床治疗困难。我们怀疑有血栓,根据其超声心动图外观,患者的癌症病史和近期静脉血栓栓塞症。患者无法坚持低分子量肝素治疗。由于预后恶化，建议姑息治疗。我们还强调了血栓和肿瘤之间的区别特征。我们提出了诊断流程图，以帮助在偶然发生心房肿块的情况下做出诊断决策。
结论：本病例报告强调了在抗癌治疗期间进行心脏肿瘤监测以检测心脏肿块的重要性。
