一例44岁女性右心房上皮样血管肉瘤：病例报告
Right Atrial Epithelioid Angiosarcoma in a 44-Year-Old Woman: A Case Report.
摘要(中文译文)
原发性心脏血管肉瘤是一种罕见且侵袭性强的恶性肿瘤，常表现为非特异性症状，导致诊断延迟。通过多模态影像学检查进行早期发现对疾病管理至关重要。患者为44岁女性，无重要既往病史，表现为六周的模糊症状，包括间歇性胸骨后烧灼样胸痛、心悸、呼吸困难、头晕及双上肢感觉异常。门诊评估中，经胸超声心动图怀疑右心房肿块。患者症状进展，伴有心率降至40余次/分的心动过缓发作，促使急诊评估。实验室检查基本无异常。CT血管造影未见肺栓塞，分期CT扫描未见转移。心脏MRI显示一个3.0×1.5 cm的广基右心房肿块，呈均匀强化。患者接受开胸手术，完整整块切除右心房壁并使用牛心包进行重建。病理证实为上皮样血管肉瘤。患者开胸手术后恢复顺利，无并发症。脑部MRI及术后PET扫描未见残留病灶或转移证据。曾建议其接受辅助化疗，但患者选择密切肿瘤学监测。本病例强调了多模态影像学在心脏肿瘤诊断中的重要性、广泛右心房切除联合重建的可行性，以及心脏血管肉瘤术后管理的复杂性。
Abstract
Primary cardiac angiosarcoma is a rare and aggressive malignancy that often presents with nonspecific symptoms, leading to delayed diagnosis. Early detection through multimodality imaging is essential for management. A 44‑year‑old woman with no significant medical history presented with six weeks of vague symptoms that included intermittent retrosternal burning chest pain, palpitations, dyspnea, lightheadedness, and bilateral arm paresthesias. Outpatient evaluation revealed a suspicion for a right atrial mass on transthoracic echocardiogram. Her symptoms progressed, accompanied by episodes of bradycardia into the 40s, prompting emergency evaluation. Laboratory studies were largely unremarkable. CT angiography showed no pulmonary embolism, and staging CT scans revealed no metastases. Cardiac MRI demonstrated a 3.0 × 1.5 cm sessile right atrial mass with homogeneous enhancement. She underwent open-heart surgery with complete en bloc resection of the right atrial wall and reconstruction using bovine pericardium. Pathology confirmed epithelioid angiosarcoma. She had an uneventful postoperative recovery from her open-heart surgery. MRI brain and postoperative PET scan showed no evidence of residual disease or metastasis. She was offered adjuvant chemotherapy but chose close oncologic surveillance. This case highlights the importance of multimodality imaging in diagnosing cardiac tumors, the feasibility of extensive right atrial resection with reconstruction, and the complexity of postoperative management in cardiac angiosarcoma.
如何引用
AMA
Jeet Shahani, Alexander Iribarne. Right Atrial Epithelioid Angiosarcoma in a 44-Year-Old Woman: A Case Report.. Cureus. 2026; doi:10.7759/cureus.110238.
APA
Jeet Shahani, Alexander Iribarne (2026). Right Atrial Epithelioid Angiosarcoma in a 44-Year-Old Woman: A Case Report.. Cureus. https://doi.org/10.7759/cureus.110238
GB/T 7714
Jeet Shahani, Alexander Iribarne. Right Atrial Epithelioid Angiosarcoma in a 44-Year-Old Woman: A Case Report.[J]. Cureus, 2026 doi:10.7759/cureus.110238.
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