PDF(Pubmed)
Abstract：
Primary cardiac tumors are rare. The cardiac sarcomas are the most common malignant cardiac tumors. These tumors have a dismal prognosis with an overall median survival of 25 months. Clinical features include dyspnea, arrhythmias, pericardial effusions, heart failure, and sudden cardiac death. The diagnosis is often challenging. Therefore, the cardiac imaging workup plays a central role in addition to a high clinical suspicion in the setting of atypical presentations that do not respond to standard therapies. The echocardiography, computed tomography, and cardiac MRI are crucial in clinching the diagnosis. Multimodal treatment with surgery, chemotherapy, and radiotherapy has been shown to improve outcomes, as opposed to using either of these modalities alone. We describe the case of a 30-year-old gentleman with COVID-19 infection who developed recurrent hemorrhagic pericardial effusions refractory to standard treatment and was eventually diagnosed as a case of pericardial angiosarcoma after his biopsy revealed the diagnosis and staging was performed using PET-CT-FDG scan. Our case re-emphasizes the importance of considering a malignant etiology early in the course of the disease presentation, especially in recurrent hemorrhagic effusions despite an inflammatory cytologic diagnosis of fluid. It also highlights the place for cardiac CT and MRI to ascertain the location and spread and to plan the further course of treatment. If diagnosed early, the estimated survival time can be prolonged by instituting a multimodal approach.
摘要：
原发性心脏肿瘤很少见。心脏肉瘤是最常见的恶性心脏肿瘤。这些肿瘤具有令人沮丧的预后,总体中位生存期为25个月。临床特征包括呼吸困难，心律失常,心包积液,心力衰竭,和心源性猝死.诊断往往具有挑战性。因此,除了临床高度怀疑对标准疗法无反应的非典型表现外,心脏影像学检查也起着重要作用.超声心动图,计算机断层扫描,心脏MRI对诊断至关重要。手术的多模式治疗，化疗,放射治疗已被证明可以改善结果，而不是单独使用这些模式中的任何一种。我们描述了一名30岁的COVID-19感染绅士的病例，他出现了标准治疗难以治疗的复发性出血性心包积液，并在活检显示诊断和分期后最终被诊断为心包血管肉瘤。PET-CT-FDG扫描。我们的病例再次强调了在疾病表现过程早期考虑恶性病因的重要性，特别是在复发性出血性积液中，尽管有炎性细胞学诊断为液体。它还强调了心脏CT和MRI的位置，以确定位置和扩散并计划进一步的治疗过程。如果早期诊断，通过建立多模式方法可以延长估计的生存时间。
