Clinical features and surgical treatment of right atrial tumors: a retrospective analysis of 64 cases

Wencheng PAN; Xuefeng WANG; Zezhou FENG; Yong WANG

doi:10.16016/j.1000-5404.202103037

您当前的位置：

首页 >

文章列表页 >

Clinical features and surgical treatment of right atrial tumors: a retrospective analysis of 64 cases

Clinical Medicine | 更新时间：2026-01-09

- Clinical features and surgical treatment of right atrial tumors: a retrospective analysis of 64 cases
- Journal of Third Military Medical University Vol. 43, Issue 16, Pages: 1587-1592(2021)
- 作者机构：
  
  400037 重庆, 陆军军医大学(第三军医大学)第二附属医院全军心血管外科研究所
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.202103037
  CLC： R181.32;R730.56;R32.1
- Received：03 March 2021，
  
  Revised：2021-04-25，
  
  Published：30 August 2021
- 稿件说明：
移动端阅览
Wencheng PAN, Xuefeng WANG, Zezhou FENG, et al. Clinical features and surgical treatment of right atrial tumors: a retrospective analysis of 64 cases[J]. Journal of Third Military Medical University, 2021, 43(16): 1587-1592.
DOI：

Wencheng PAN, Xuefeng WANG, Zezhou FENG, et al. Clinical features and surgical treatment of right atrial tumors: a retrospective analysis of 64 cases[J]. Journal of Third Military Medical University, 2021, 43(16): 1587-1592. DOI： 10.16016/j.1000-5404.202103037.

摘要

目的

探讨右心房肿瘤的临床特点、外科治疗效果及经验。

方法

收集2009年1月至2021年1月我科收治的64例右心房肿瘤的病例资料，总结分析其临床资料、手术要点、术后并发症及转移复发情况。

结果

本组总体良性肿瘤占比78.1%，恶性肿瘤占比21.9%；手术组良性肿瘤占比83.0%，恶性肿瘤占比17.0%。患者最常见的临床症状前三位依次为疲乏、胸闷胸痛或心前区不适感、面部或下肢水肿，最常见的术前合并症为房颤/房扑，其次为肺栓塞。住院总死亡率为3.1%，在院术后死亡率为1.9%。良性肿瘤患者中残留下腔静脉远端瘤栓无法取出1例；心律失常需介入手术干预1例；三尖瓣中至重度反流3例；转移性复发2例。接受手术的恶性肿瘤患者早期死亡1例，6例在半月到2年7个月间转移复发，2例失访。

结论

右心房肿瘤多为原发性良性肿瘤。手术治疗良性右心房肿瘤，即使对于复发病例，均安全且有效；选择性手术治疗恶性右心房肿瘤可改善血流动力学和临床症状，但总体预后不良。

Abstract

Objective

To investigate the clinical characteristics of right atrial tumors and to analyze the experience and efficacy of surgical treatment.

Methods

The clinical data of 64 patients (37 females and 27 males

at a mean age of 47.0±16.4 years) with right atrial tumors admitted to our hospital from January 2009 to January 2021 were retrospectively collected and analyzed. The clinical features

surgery techniques adopted

postoperative complications and metastatic recurrence of patients were summarized in detail.

Results

Among all the 64 cases

benign tumors accounted for 78.1% and malignant tumors for 21.9%; while among the 53 patients who underwent surgical treatment

83.0% of the tumors were benign and 17.0% malignant. The top 3 most common clinical symptoms involved fatigue

chest tightness and pain or precordial discomfort

and facial or lower limbs edema. And the most frequent preoperative complications were atrial fibrillation/flutter

followed by pulmonary embolism. Moreover

the overall in-hospital mortality rate was 3.1%

and the postoperative mortality rate 1.9%. Among the patients with benign tumors

1 had residual tumor thrombus at the distal end of inferior vena cava

1 occurred arrhythmia requiring surgical intervention

3 developed moderate to severe tricuspid regurgitation

and 2 had metastatic recurrences. In the patients with malignant tumors who received surgery

1 died early postoperatively

6 developed metastatic recurrences between half a month and 2 years plus 7 months

and 2 cases were lost during follow-up.

Conclusion

Primary benign tumor is the major type of right atrial tumors. Surgical treatment for benign tumors is safe and effective

even in recurrent cases. Selective surgical treatment for malignant tumors can improve hemodynamics and clinical symptoms

though the overall prognosis tends to be poor.

关键词

Keywords

references

HOFFMEIER A, SINDERMANN J R, SCHELD H H, et al . Cardiac tumors: diagnosis and surgical treatment[J ] . Dtsch Arztebl Int, 2014, 111(12): 205-211. DOI: 10.3238/arztebl.2014.0205.

MCALLISTER H, FENOGLIO J. Tumors of the cardiovascular system[J]. Atlas of tumor pathology, 1978, 1-20. DOI: 10.1007/978-1-60327-372-5_1.

BUSSANI R, CASTRICHINI M, RESTIVO L, et al . Cardiac tumors: diagnosis, prognosis, and treatment[J ] . Curr Cardiol Rep, 2020, 22(12): 169. DOI: 10.1007/s11886-020-01420-z.

LI H, GUO H, XIONG H, et al . Clinical features and surgical results of right atrial myxoma[J ] . J Card Surg, 2016, 31(1): 15-17. DOI: 10.1111/jocs.12663.

SHETTY ROY A N, RADIN M, SARABI D, et al . Familial recurrent atrial myxoma: Carney's complex[J ] . Clin Cardiol, 2011, 34(2): 83-86. DOI: 10.1002/clc.20845.

PUCCI A, GAGLIARDOTTO P, ZANINI C, et al . Histopathologic and clinical characterization of cardiac myxoma: Review of 53 cases from a single institution[J ] . Am Heart J, 2000, 140(1): 134-138. DOI: 10.1067/mhj.2000.107176.

KODAMA H, HIROTANI T, SUZUKI Y, et al . Cardiomyogenic differentiation in cardiac myxoma expressing lineage-specific transcription factors[J ] . Am J Pathol, 2002, 161(2): 381-389. DOI: 10.1016/s0002-9440(10)64193-4.

SAHITYA V, ANANDAM G, SHASTRY S. Right atrial myxoma in a 65-year-old female: a rare presentation[J]. Med J Dr D Y Patil Vidyapeeth, 2018, 11(6): 551. DOI: 10.4103/mjdrdypu.mjdrdypu_66_18.

YOKOMURO H, YOSHIHARA K, WATANABE Y, et al . The variations in the immunologic features and interleukin-6 levels for the surgical treatment of cardiac myxomas[J ] . Surg Today, 2007, 37(9): 750-753. DOI: 10.1007/s00595-006-3448-6.

BURKE A, TAVORA F. The 2015 WHO classification of tumors of the heart and pericardium[J]. J Thorac Oncol, 2016, 11(4): 441-452. DOI: 10.1016/j.jtho.2015.11.009.

KOSHY A N, KOSHY G, HARDIKAR A A. Intracardiac lipoma arising from the papillary muscle[J]. J Card Surg, 2011, 26(1): 65-66. DOI: 10.1111/j.1540-8191.2010.01156.x.

SCHREPFER S, DEUSE T, DETTER C, et al . Successful resection of a symptomatic right ventricular lipoma[J ] . Ann Thorac Surg, 2003, 76(4): 1305-1307. DOI: 10.1016/S0003-4975(03)00523-X.

LI W, TENG P, XU H, et al . Cardiac Hemangioma: A Comprehensive Analysis of 200 Cases[J ] . Ann Thorac S urg, 2015, 99(6): 2246-2252. DOI: 10.1016/j.athoracsur.2015.02.064.

杨秋蓝, 唐兵, 周晓辉, 等. 心脏海绵状血管瘤的临床表现及外科手术疗效分析[J]. 中华心血管病杂志, 2017, 45(9): 786-790.

YANG Q L, TANG B, ZHOU X H, et al . Clinical features and surgical treatment effect of patients with cardiac cavernous hemangioma[J ] . Chin J Cardiol, 2017, 45(9): 786-790.

UNGER E, COSTIC J, LAUB G. Giant cardiac cavernous hemangioma[J]. Ann Thorac Surg, 2015, 100(1): 322-325. DOI: 10.1016/j.athoracsur.2014.08.056.

赵丽红, 王金山, 蒋萍, 等. 心脏和肺上皮样血管内皮细胞瘤一例[J]. 中华肿瘤杂志, 2015, 37(4): 265.

ZHAO L H, WANG J S, JIANG P, et al . A case of cardiac and pulmonary epithelioid hemangioendothelioma. Chin J Oncol, 2015, 37(4): 265.

HERRMANN M A, SHANKERMAN R A, EDWARDS W D, et al . Primary cardiac angiosarcoma: a clinicopathologic study of six cases[J ] . J Thorac Cardiovasc Surg, 1992, 103(4): 655-664.

GALIUT L. The EAE textbook of echocardiography/[M]// The EAE textbook of echocardiography. 1st edition. Oxford University Press, 2011.

SIMPSON L, KUMAR S K, OKUNO S H, et al . Malignant primary cardiac tumors: review of a single institutionexperience[J ] . Cancer, 2008, 112(11): 2440-2446. DOI: 10.1002/cncr.23459.

BOUMA W, LEXIS C P, WILLEMS T P, et al . Successful surgical excision of primary right atrial angiosarcoma[J ] . J Cardiothorac Surg, 2011, 6: 47. DOI: 10.1186/1749-8090-6-47.

RAMLAWI B, LEJA M J, ABU SALEH W K, et al . Surgical treatment of primary cardiac sarcomas: review of a single-institutionexperience[J ] . Ann Thorac Surg, 2016, 101(2): 698-702. DOI: 10.1016/j.athoracsur.2015.07.087.

张羽冠, 沙悦, 程午樱, 等. 以咯血首发右心房血管肉瘤1例[J]. 协和医学杂志, 2014, 5(2): 217-220. DOI: 10.3969/j.issn.1674-9081.2014.02.020.

YANG Y G, SHA Y, CHENG W Y, et al . One case report of right atrial angiosarcoma with hemopthsis as first symptom[J ] . Med J Peking Union Med Coll Hosp, DOI: 10.3969/j.issn.1674-9081.2014.02.020.

OLIVEIRA G H, AL-KINDI S G, HOIMES C, et al . Cha- racteristics and survival of malignant cardiac tumors: a 40-ye ar analysis of > 500 patients[J ] . Circulation, 2015, 132(25): 2395-2402. DOI: 10.1161/circulationaha.115.016418.

KAKIZAKIA S, TAKAGIB H, HOSAKAC Y. Cardiac angiosarcoma responding to multidisciplinary treatment[J]. Int J Cardiol, 1997, 62(3): 273-275. DOI: 10.1016/S0167-5273(97)00259-3.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Primary cardiac tumors: clinical analysis of 129 patients

Diagnostic value of endoscopic LCPL sign for high-risk intestinal metaplasia in gastric mucosa

Construction of a diagnostic model for chronic mountain sickness among young male migrants to high-altitude areas

Congenital inner ear deformity with spontaneous cerebrospinal fluid leakage: a case series report of 9 children

Application of Hess automatic screen recording system in diagnosis of acquired paralytic strabismus

Related Author

陈林

肖颖彬

陈柏成

王学锋

钟前进

陈劲进

郝嘉

王咏

Related Institution

Department of Gastroenterology， Chongqing Key Laboratory of Precise Prevention and Treatment of Digestive Malignancies

Department of Pathology， Army Medical Center of PLA/Daping Hospital of Third Military Medical University， Chongqing

First Clinical College of Chongqing Medical University

Department of High Altitude Physiology and Pathology, Faculty of High Altitude Military Medicine， Army Medical University （Third Military Medical University）

Department of Medicine and Hygienic Equipment for High Altitude Region, Faculty of High Altitude Military Medicine， Army Medical University （Third Military Medical University）

⁰