Case Report Malignant Fibrous Histiocytoma of the Heart Case Report of a Rare Left-Atrial Tumor B. Korbmcc her, C Doering. 11. D. Sc hulte. an d W Hart· Department of Thoracic and Cardiovascular Surgery • Departmen t of Path ology. ll E'inrn:h -ll eine -Uni\"ers ity of Duesse jdc rf Germa ny
nw pn-s ont report duscrlbr-s 11m (~U Sl) n£ 11 57 -yea r-old patient with lllaligna nt nbrous histinry iumu uf tim len atrium ope rated uu for II s uspected atria l myxoma . Surw' ry w as per fo rmed as radieally li S possible an d Included resecuun uf the at rial walL Cuntcu l investigation a nd echucu rdillj.,'l'llilhy performed 29 months aner su rgery revealed no slgns of tumor recurrence. I>ill/(Ilos tic procedu res . to pogra phy, pathohistolngy as well as options for therapy are discussed w ith r~a rd to the latest litera ture. A radica l sUrgica l ap proarh T('PT("SCO ts the only effecuve thera peutic measure. Owing to a la r k of sufficie nt expertenre , there is no additional tnc rapecue recommendation on hand. r-ol"ithl"r radiation nor ehr- me the ra pcuuc treatment conr cpu.. ha ve proved ('fficl('nt. Echocardiography represents the besr oxammauon proced ure for both diagnosis and follow-up in pa uents ....i th ca rdiae tumor. Kr )'
words
\ lall J(m· s Ills llo;r.ytom d es Ih' u I' ns I-'llllbt' r khl ti be r- ej ne n soltene n Ilnks lll rlllh' n Tum or
uerernem 5 7 J ahr e alton Pauen ten wurd.. tlnt.'r d"1ll Vprdae ht erues Vor hofrnyx oms ein mahgnus filJrlisp s lIistioyztum des llnken Vor hofs opo rte rt. Die Hesnkucn wur de s n radikal wi.. lII!iJ.:hch ur uer Einschl ufi de r Vorh ofwan d a usJ.:,'fiihrt. DiE' khnisrhe Untcrsuchung und Ec hokard iogra phi l~ l l'i},,'1(' 29 \ lona w pus tnp erativ kelne Hinwelse a uf ein Tumurrexldt v, Il iagnos tis r h., MaBna h men . Topographic. Morpholngil' lind therapeuusehe Mog!ichkcileo werden unter 1J(·ru r ksir htiWJng do r neuerr- n Litere rur diskuti crt . Die ra dikale chirurgiSl'h l' Ill'Sl'k tion stl"l1l d l(' t'innge errekuve therapeutische MaBnahm(' da r. ,\ ufwu nd man gelnder Erfa hrung Siehl kt'il1 l' lllsat7Jirhl' Therapie empfehtung zur ve rtugung. wede r strahlen - ouch r hernnthe rapeuusche Konzepte ha bcn sic h blsh er als wtrksam erwiesen. Oil' Ec hoka rdicgrap hie ist di ll bes tc Dntersurhungsmethode Iiir Diagnosti k lind Nachuntcrsuehung bei Paur-nu-n mit Hernu mcren .
Hea rt tumor - IIisti0111uma
Introd uct ion Pr ima ry ma lignan t tumo rs of the heart a re extre mely ra re a nd a uniform the rapeutic option does not se em to be availa ble. In our clinic. 6 3 patie nts underwent surgery for cardille tum ors betw een 1958 and 1990 with seven of the m bl!ing malig na nt . Among these 7 ma lignant was 1 mali gna nt fibrous histiocytoma. This unexpe cted findin g is presented a nd d iscussed be low. On the basis of histological examination. primary ma lignant fibrou s histiocytoma s ma ke up 10 to 15 % of a ll so fttissue sarcomas . Surgic-al resection of the tum ors repre se nts the endpoint of curative therapy. Ho pi ss and Enzinger (27) re port on 200 patien ts with ma lignan t fibrou s histiocytoma. 196 of these patie nts were treated su rgica lly. Th ere wa s no evidence of metasta ses or local recurrences in 6 3 pati en ts (32 %). One or more local recurren ces occur ed in 51 (211 % ) pa tien ts an d metas tas es oceured in 82 (42 %). With ra dical surgery the prognosis of malignant fibro us sa rco ma with peripheral loca liza tion is considered
Thorne. rurdiovasr'. Surgeon 40 (1'1
nw pn-s ont report duscrlbr-s 11m (~U Sl) n£ 11 57 -yea r-old patient with lllaligna nt nbrous histinry iumu uf tim len atrium ope rated uu for II s uspected atria l myxoma . Surw' ry w as per fo rmed as radieally li S possible an d Included resecuun uf the at rial walL Cuntcu l investigation a nd echucu rdillj.,'l'llilhy performed 29 months aner su rgery revealed no slgns of tumor recurrence. I>ill/(Ilos tic procedu res . to pogra phy, pathohistolngy as well as options for therapy are discussed w ith r~a rd to the latest litera ture. A radica l sUrgica l ap proarh T('PT("SCO ts the only effecuve thera peutic measure. Owing to a la r k of sufficie nt expertenre , there is no additional tnc rapecue recommendation on hand. r-ol"ithl"r radiation nor ehr- me the ra pcuuc treatment conr cpu.. ha ve proved ('fficl('nt. Echocardiography represents the besr oxammauon proced ure for both diagnosis and follow-up in pa uents ....i th ca rdiae tumor. Kr )'
words
\ lall J(m· s Ills llo;r.ytom d es Ih' u I' ns I-'llllbt' r khl ti be r- ej ne n soltene n Ilnks lll rlllh' n Tum or
uerernem 5 7 J ahr e alton Pauen ten wurd.. tlnt.'r d"1ll Vprdae ht erues Vor hofrnyx oms ein mahgnus filJrlisp s lIistioyztum des llnken Vor hofs opo rte rt. Die Hesnkucn wur de s n radikal wi.. lII!iJ.:hch ur uer Einschl ufi de r Vorh ofwan d a usJ.:,'fiihrt. DiE' khnisrhe Untcrsuchung und Ec hokard iogra phi l~ l l'i},,'1(' 29 \ lona w pus tnp erativ kelne Hinwelse a uf ein Tumurrexldt v, Il iagnos tis r h., MaBna h men . Topographic. Morpholngil' lind therapeuusehe Mog!ichkcileo werden unter 1J(·ru r ksir htiWJng do r neuerr- n Litere rur diskuti crt . Die ra dikale chirurgiSl'h l' Ill'Sl'k tion stl"l1l d l(' t'innge errekuve therapeutische MaBnahm(' da r. ,\ ufwu nd man gelnder Erfa hrung Siehl kt'il1 l' lllsat7Jirhl' Therapie empfehtung zur ve rtugung. wede r strahlen - ouch r hernnthe rapeuusche Konzepte ha bcn sic h blsh er als wtrksam erwiesen. Oil' Ec hoka rdicgrap hie ist di ll bes tc Dntersurhungsmethode Iiir Diagnosti k lind Nachuntcrsuehung bei Paur-nu-n mit Hernu mcren .
Hea rt tumor - IIisti0111uma
Introd uct ion Pr ima ry ma lignan t tumo rs of the heart a re extre mely ra re a nd a uniform the rapeutic option does not se em to be availa ble. In our clinic. 6 3 patie nts underwent surgery for cardille tum ors betw een 1958 and 1990 with seven of the m bl!ing malig na nt . Among these 7 ma lignant was 1 mali gna nt fibrous histiocytoma. This unexpe cted findin g is presented a nd d iscussed be low. On the basis of histological examination. primary ma lignant fibrou s histiocytoma s ma ke up 10 to 15 % of a ll so fttissue sarcomas . Surgic-al resection of the tum ors repre se nts the endpoint of curative therapy. Ho pi ss and Enzinger (27) re port on 200 patien ts with ma lignan t fibrou s histiocytoma. 196 of these patie nts were treated su rgica lly. Th ere wa s no evidence of metasta ses or local recurrences in 6 3 pati en ts (32 %). One or more local recurren ces occur ed in 51 (211 % ) pa tien ts an d metas tas es oceured in 82 (42 %). With ra dical surgery the prognosis of malignant fibro us sa rco ma with peripheral loca liza tion is considered
Thorne. rurdiovasr'. Surgeon 40 (1'1
