Abstract:
Cardiac tumors, due to the various clinical scenarios and their histological subtypes, are still challenging for clinicians. They are differentiated into primary and secondary. The latest are more common and are usually lung and breast cancers, melanomas, and lymphoma metastasis. We present a case of a 73-year-old woman, with a history of breast cancer 10 years earlier, admitted to Cath lab for an elevation of the ST-segment of the electrocardiogram, myocardial infarction. Echocardiogram showed a curious abnormality in the myocardial wall. Thanks to a multimodality imaging strategy, including contrast-enhanced echocardiography and cardiac magnetic resonance, characterization of the underlying pathology was clear and, thus, the appropriate management and therapy.
This is the case of a cardiac metastatic tumor, whose certain diagnosis can only be made by myocardial biopsy – an invasive sample of heart tissue – unfortunately not available in our case. Alternatively, we puzzled data from two second-level imaging techniques: contrast-enhanced cardiac ultrasound and cardiac magnetic resonance, which allowed us to better evaluate the nature of this cardiac mass. The former gave information about its blood supply, the latter gave information about tissue characterization. In this paper, we show how a complete integration of data from clinical and a stepwise multimodality imaging-based approach may allow a diagnosis in a complex clinical case.
摘要:
心脏肿瘤,由于各种临床情况及其组织学亚型,对临床医生来说仍然具有挑战性。它们分为主要和次要。最新的更常见,通常是肺癌和乳腺癌,黑色素瘤,和淋巴瘤转移。我们提出了一个73岁的女人的案例,10年前有乳腺癌病史,因心电图ST段抬高而进入Cath实验室,心肌梗塞。超声心动图显示心肌壁奇怪的异常。多亏了多模态成像策略,包括对比增强超声心动图和心脏磁共振,潜在病理的特征是明确的,因此,适当的管理和治疗。
这是心脏转移性肿瘤的例子,其某些诊断只能通过心肌活检-心脏组织的侵入性样本-不幸的是在我们的病例中不可用。或者,我们困惑的数据来自两个二级成像技术:对比增强心脏超声和心脏磁共振,这使我们能够更好地评估这种心脏质量的性质。前者提供了血液供应的信息,后者提供了有关组织表征的信息。在本文中,我们展示了临床数据的完全整合和基于多模态成像的逐步方法如何可以在复杂的临床病例中进行诊断.