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心脏肿瘤的诊断与治疗。

Diagnosis and treatment of cardiac tumors.

作者信息

Imai Toru, Shimoi Tatsunori, Kawai Akira, Yonemori Kan

机构信息

Department of Medical Oncology, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan.

Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan.

出版信息

Med Oncol. 2025 Mar 17;42(4):110. doi: 10.1007/s12032-025-02661-0.

Abstract

Cardiac tumors, though rare, present significant diagnostic and therapeutic challenges due to their diverse nature and potential severity. These tumors, which can be primary or metastatic, are often detected incidentally through imaging modalities such as echocardiography or CT scans. Differentiating between benign and malignant forms is crucial for guiding appropriate management strategies. This review synthesizes current diagnostic approaches and treatment modalities for cardiac tumors, with a focus on the role of imaging techniques like UCG, CT, MRI, and PET in tumor characterization. Multidisciplinary treatment plans are necessary, including surgical resection for benign tumors, chemotherapy, and radiotherapy for malignant tumors, and novel targeted therapies such as MDM2 inhibitors for selected cases. While primary malignant tumors like sarcomas and mesotheliomas exhibit rapid progression and poor prognosis, recent advances in multimodal therapy offer potential improvements in survival. The incidence of primary cardiac tumors is low, with an autopsy-reported occurrence rate of 0.02%. Benign cardiac tumors, such as myxomas and fibromas, generally have favorable outcomes with surgical resection. In contrast, primary malignant tumors like sarcomas and mesotheliomas exhibit rapid progression and poor prognosis, necessitating aggressive treatment including surgery, chemotherapy, and radiotherapy. Metastatic cardiac tumors occur in approximately 10% of cancer patients at autopsy and are managed according to the treatment plan for the primary malignancy. The management of cardiac tumors requires a multidisciplinary approach tailored to tumor type, location, and systemic effects. While benign tumors often respond well to surgical management, malignant and metastatic tumors demand more complex strategies to optimize patient outcomes.

摘要

心脏肿瘤虽然罕见,但由于其性质多样且潜在严重性,在诊断和治疗方面面临重大挑战。这些肿瘤可以是原发性的或转移性的,通常通过超声心动图或CT扫描等成像方式偶然发现。区分良性和恶性形式对于指导适当的管理策略至关重要。本综述综合了目前心脏肿瘤的诊断方法和治疗方式,重点关注超声心动图(UCG)、CT、MRI和PET等成像技术在肿瘤特征描述中的作用。多学科治疗计划是必要的,包括对良性肿瘤进行手术切除,对恶性肿瘤进行化疗和放疗,以及针对特定病例使用MDM2抑制剂等新型靶向治疗。虽然肉瘤和间皮瘤等原发性恶性肿瘤进展迅速且预后不良,但多模态治疗的最新进展为提高生存率提供了可能。原发性心脏肿瘤的发病率较低,尸检报告的发生率为0.02%。良性心脏肿瘤,如黏液瘤和纤维瘤,手术切除后通常预后良好。相比之下,肉瘤和间皮瘤等原发性恶性肿瘤进展迅速且预后不良,需要积极治疗,包括手术、化疗和放疗。转移性心脏肿瘤在尸检中约占癌症患者的10%,并根据原发性恶性肿瘤的治疗计划进行管理。心脏肿瘤的管理需要根据肿瘤类型、位置和全身影响采取多学科方法。虽然良性肿瘤通常对手术治疗反应良好,但恶性和转移性肿瘤需要更复杂的策略来优化患者预后。

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