病例报告：以肋骨疼痛为首发症状的心脏血管肉瘤
Case Report: Cardiac angiosarcoma with rib pain as the first symptom.
摘要(中文译文)
原发性心脏血管肉瘤（PCAS）是一种罕见的、高度侵袭性的恶性肿瘤，预后极差。我们报告一例34岁女性患者，无外伤史，最初表现为持续性肋骨疼痛，被误诊为肋软骨炎。全面评估发现多发性溶骨性骨转移源自右心房原发性心脏血管肉瘤，并伴有环周性心包积液。尽管启动了姑息性化疗和放疗，患者仍在确诊五个月后因疾病进展而死亡。本病例强调了三个关键的临床考量：（1）转移性骨受累可能仅表现为局部、难治性疼痛；（2）孤立性疼痛而无明显心脏症状，给诊断带来重大挑战，并存在延迟识别的风险；（3）不明原因的骨痛——尤其是当同时伴有心包积液时——需要及时进行多模态影像学检查以及涉及肿瘤科、心脏科和疼痛医学科的多学科评估。通过详细描述其临床、影像学及组织病理学表现，我们旨在提高疼痛专科医师和肿瘤科医师对这种罕见但危及生命的心脏恶性肿瘤的认识，并倡导在不典型疼痛表现中更早地考虑该诊断。
Abstract
Primary cardiac angiosarcoma (PCAS) is a rare, highly aggressive malignancy characterized by a dismal prognosis. We present a case of a 34-year-old woman with no history of trauma who initially presented with persistent rib pain misdiagnosed as costochondritis. Comprehensive evaluation revealed multiple osteolytic bone metastases originating from a right atrial PCAS, accompanied by circumferential pericardial effusion. Despite initiation of palliative chemotherapy and radiotherapy, the patient succumbed to progressive disease five months after diagnosis. This case underscores three critical clinical considerations: (1) metastatic bone involvement may manifest solely as localized, refractory pain; (2) isolated pain without overt cardiac symptoms poses significant diagnostic challenges and risks delayed recognition; and (3) unexplained bone pain-particularly when concurrent with pericardial effusion-warrants prompt multimodal imaging and interdisciplinary evaluation involving oncology, cardiology, and pain medicine. By detailing the clinical, radiological, and histopathological findings, we aim to raise awareness among pain specialists and oncologists of this rare yet life-threatening cardiac malignancy and to advocate earlier diagnostic suspicion in atypical pain presentations.
如何引用
AMA
Meng Cai, Xiaodi Chen, Jie Li, Rong Liu, Chang Zhou. Case Report: Cardiac angiosarcoma with rib pain as the first symptom.. Frontiers in oncology. 2026; doi:10.3389/fonc.2026.1815522.
APA
Meng Cai, Xiaodi Chen, Jie Li, Rong Liu, Chang Zhou (2026). Case Report: Cardiac angiosarcoma with rib pain as the first symptom.. Frontiers in oncology. https://doi.org/10.3389/fonc.2026.1815522
GB/T 7714
Meng Cai, Xiaodi Chen, Jie Li, Rong Liu, Chang Zhou. Case Report: Cardiac angiosarcoma with rib pain as the first symptom.[J]. Frontiers in oncology, 2026 doi:10.3389/fonc.2026.1815522.
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