心脏内平滑肌瘤病伴腹盆腔巨大肿瘤的多学科综合诊治策略(附2例报告)

目的:探讨心脏内平滑肌瘤病伴腹盆腔巨大肿瘤的多学科综合诊治策略。方法:回顾性分析我院收治的2例心脏内平滑肌瘤病伴腹盆腔巨大肿瘤病人的临床资料,并对相关文献进行复习。结果:2例病人均行一期手术,完整切除原发肿瘤、静脉内瘤栓、全子宫及双侧附件。1例切开右心房摘除心脏及下腔静脉内瘤栓;1例切开右心房及下腔静脉摘除心脏及下腔静脉内瘤栓。术后病理诊断为静脉内平滑肌瘤病。无围手术期死亡及并发症发生。结论:术前应全面评估心脏内平滑肌瘤病伴腹盆腔肿瘤的临床资料,制定多学科协作手术方案,一期经胸和腹联合手术是安全、可行的。

Multidisciplinary therapeutic approach for intracardiac leiomyomatosis with enormous mass in abdominal and pelvic cavity:2 cases report

Objective To investigate the multidisciplinary therapeutic approach of two cases with intracardiac leiomyomatosis with enormous mass in abdominal and pelvic cavity.Methods The clinical data with two cases of intracardiac leiomyomatosis with enormous mass in abdominal and pelvic cavity was reviewed retrospectively with related literatures.Results A single-stage procedure with combined thoracic and abdominal approach was performed successfully.The procedure involved removal of the tumor and atrial,caval,other venular extensions,and total hysterectomy with bilateral salpingo-oophorectomy as well.The intravenous tumor embolus was removed completely through a right atrial in one case and through both right atrial and inferior vena cava in the other case.It was showed pathologically intravenous leiomyomatosis in both cases after postoperation.No peri-operative death and complication occurred.Conclusions For patient of intracardiac leiomyomatosis with enormous mass in abdominal and pelvic cavity,the clinical data should be comprehensively assessed preoperatively so as to make a multidisciplinary surgical protocol.Single stage trans-thoracic and abdominal operation is safe and feasible.