Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지

Surgical Treatment of Cardiac Tumor

심장에 발생한 종양의 수술적 치료

  • Jung, Tae-Eun (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Yeungnam University) ;
  • Han, Sung-Sae (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Yeungnam University) ;
  • Lee, Dong-Hyup (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Yeungnam University)
  • 정태은 (영남대학교 의과대학 흉부외과학교실) ;
  • 한승세 (영남대학교 의과대학 흉부외과학교실) ;
  • 이동협 (영남대학교 의과대학 흉부외과학교실)
  • Published : 2006.11.05
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Tumors of the heart are uncommon. The aim of this study is to review our clinical experience and outcome of surgical treatment of cardiac neoplasm. Material and Method: From March 1990 to December 2005, 35 patients(14 males and 21 females) with mean age of 52.4 years underwent surgical treatment of cardiac neoplasm. The clinical and pathologic data were analyzed retrospectively. Surgical treatment consisted in complete resection of the tumor in all cases but 1 patient who was left ventricular fibroma received biopsy only. Result: Thirty cases were benign and five cases were malignant tumor. Benign tumors were myxoma(29 cases) and fibroma(1 case). Five malignant tumors were osteosarcoma, hepatocellular carcinoma, renal cell cancer, yolk sac tumor, and unclassified myxoid spindle cell type sarcoma. There were no operative mortality in benign cases and twenty seven cases of myxoma were followed up for 8 months to 15 years without recurrence. But four patients of malignant tumor were expired within six months after operation. Conclusion: Left atrial myxomas are most common benign neoplasm. Surgical treatment is effective for the benign cardiac tumors but prognosis is poor in patients with malignant cardiac tumors.

배경: 심장에 발생하는 종양은 흔치 않다. 심장종양의 종양에 대한 임상적 특징과 수술 결과를 조사하였다. 대상 및 방법: 1990년 3월부터 2005년 12월까지 35명(남자14명, 여자 21명)의 환자를 대상으로 하였으며 평균 나이는 52.4세였다. 임상 및 병리학적 조사를 후향적으로 시행하였다. 수술은 좌심실 섬유종 1예를 제외한 전 예에서 완전 절제술을 시행하였다. 결과: 양성은 30예였으며 그중 점액종이 29예, 섬유종이 1예였다. 악성은 5예로 골육종, 미분류 점액성 육종, 간세포암, 신세포암, 그리고 난황낭암이 각 1예였다. 양성인 경우 수술 사망은 없었으며 완전절제 후 추적이 가능했던 27예의 경우 재발된 예는 없었다. 악성의 경우 4예가 술 후 6개월 이내에 사망하였다. 결론: 좌심방의 점액종이 가장 많았으며 양성의 경우 외과적 치료는 효과적이었으나 악성인 경우 예후는 매우 불량하였다.

Keywords

References

  1. Centofanti P, Di Rosa E, Deorsola L, et al. Primary cardiac tumors: early and late results of surgical treatment in 91 patients. Ann Thorac Surg 1999;68:1236-41 https://doi.org/10.1016/S0003-4975(99)00700-6
  2. Abushaban L, Denham B, Duff D. 10 year review of cardiac tumours in childhood. Br Heart J 1993;70:166-9 https://doi.org/10.1136/hrt.70.2.166
  3. Muhler EG, Kienast W, Turniski-Harder V, von Bernuth G. Arrhythmias in infants and children with primary cardiac tumours. Eur Heart J 1994;15:915-21 https://doi.org/10.1093/oxfordjournals.eurheartj.a060610
  4. Yu SH, Lim SH, Hong YS, et al. Clinical experiences for primary cardiac tumors. Korean J Thorac Cardiovasc Surg 2005;38:301-7
  5. Kang JK, Yoon YS, Kim HT, Lee CJ, Park ID. Surgical management of primary cardiac tumor: early and late results. Korean J Thorac Cardiovasc Surg 2004;37:228-34
  6. Park SY, Moon SW, Kim CK, et al. Surgical treatment of primary cardiac tumor -report of 27 cases-. Korean J Thorac Cardiovasc Surg 1998;31:787-91
  7. Yeo SD, Kim EJ, Lim SP, Lee Y. Primary malignant cardiac tumor. Korean J Thorac Cardiovasc Surg 1992;25:1265-8
  8. Reynen K. Cardiac myxomas. N Engl J Med 1995;333:1610-7 https://doi.org/10.1056/NEJM199512143332407
  9. Pinede L, Duhaut P, Loire R. Clinical presentation of left atrial cardiac myxoma: a series of 112 consecutive cases. Medicine 2001;80:159-72 https://doi.org/10.1097/00005792-200105000-00002
  10. Carney JA. Differences between nonfamilial and familial cardiac myxoma. Am J Surg Pathol 1985;9:53-5 https://doi.org/10.1097/00000478-198501000-00009
  11. Jones DR, Warden HE, Murray GF, et al. Biatrial approach to cardiac myxoma: a 30-year clinical experience. Ann Thorac Surg 1995;59:851-6 https://doi.org/10.1016/0003-4975(95)00064-R
  12. Gray IR, Williams WG. Recurring cardiac myxoma. Br Heart J 1985;53:645-9 https://doi.org/10.1136/hrt.53.6.645
  13. Hishitani T, Ogawa K, Hoshino K, Kido S, Nakamura Y, Ogawa Y. Malignant fibrosarcoma with features of myxoma. Pediatr Cardiol 2001;22:258-9 https://doi.org/10.1007/s002460010218
  14. Prager RL, Dean R, Turner B. Surgical approach to intracardiac renal cell carcinoma. Ann Thorac Surg 1982;33:74-7 https://doi.org/10.1016/S0003-4975(10)63202-X
  15. Reece IJ, Cooley DA, Frazier OH, Hallman GL, Powers PL, Montero CG. Cardiac tumors. Clinical spectrum and prognosis of lesions other than classical benign myxoma in 20 patients. J Thorac Cardiovasc Surg 1984;88:439-46
  16. Shahian DM, Libertino JA, Zinman LN, Leonardi HK, Eyre RC. Resection of cavoatrial renal cell carcinoma employing total circulatory arrest. Arch Surg 1990;125:727-31 https://doi.org/10.1001/archsurg.1990.01410180045009
  17. Fujisaki M, Kurihara E, Kikuchi K, Nishikawa K, Uematsu Y. Hepatocellular carcinoma with tumor thrombus extending into the right atrium: report of a successful resection with the use of cardiopulmonary bypass. Surgery 1991;109:214-9
  18. Kleisli T, Raissi SS, Nissen NN, et al. Cavo-atrial tumor resection under total circulatory arrest without a sternotomy. Ann Thorc Surg 2006;81:1887-8 https://doi.org/10.1016/j.athoracsur.2005.05.054
  19. Shinghal R, Vricella LA, Mitchell RS, Presti J Jr. Cavoatrial tumor thrombus excision without circulatory arrest. Urology 2003;62:138-40 https://doi.org/10.1016/S0090-4295(03)00258-9
  20. Bakaeen FG, Reardon MJ, Coselli JS, et al. Surgical outcome in 85 patients with primary cardiac tumors. Am J Surg 2003;186:641-7 https://doi.org/10.1016/j.amjsurg.2003.08.004