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相關文獻
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頁籤選單縮合
| 題 名 | Cardiac Tumors in Infants and Children=孩童之心臟腫瘤 |
|---|---|
| 作 者 | 王玠能; 姚志達; 陳建旭; 楊友任; 蔡友謙; 吳俊明; | 書刊名 | 臺灣兒科醫學會雜誌 |
| 卷 期 | 44:4 民92.07-08 |
| 頁 次 | 頁215-219+257 |
| 分類號 | 417.522 |
| 關鍵詞 | 心臟腫瘤; 橫紋肌瘤; 結節性硬化症; Cardiac tumor; Rhabdomyoma; Tuberous sclerosis; |
| 語 文 | 英文(English) |
| 中文摘要 | 兒童的心臓腫瘤是十分少見的，其臨床表現可能輕微或沒有症狀，但若嚴重時會威協生命徵象。由於診斷工具的時步，例如心臓超音波；可以早期偵測到還沒有症狀的心臓腫瘤。從民國78年7月到91年7月，總共有15個病例在本院診斷爲心臓腫瘤；男與女的比例爲10:5，年齡由天到9歲。其中原發性的腫瘤共有11例（包括橫紋肌瘤10例，纖維瘤1例）；次發轉移性的腫瘤共有4例（肝母細胞瘤2例，肝癌1例，以及橫紋肌肉1瘤例）。在橫紋肌瘤的10命名 合併有結節性化症的病患有9例(90%)。病童的臨床表現包括呼吸急促（5例），抽搐（4例），心雜音（6例）以及發紺（3例）。三例原發性腫瘤病患接受開刀治療。其中2例是因爲有腫瘤阻塞導致血流力學狀態不穩定而開刀，另一例是因爲有其他先天性心臓畸形而開刀。原發性的心臓腫瘤在5個合併結節硬化症的病人中有自發性的逐漸變小。所有4個轉移腫瘤的病人都接受化學治療，但只有一個病人的腫瘤在化學治療後有縮小。根據我們的經驗，我們認爲(1)橫紋肌瘤是兒童最常見的心臓腫瘤，(2)臨床表現的嚴重度取決於腫瘤的大小，數目以及是否占滿了心臓腔室而有血流阻塞的現象，(4)在原發性腫瘤中是有機會自發性的變小，而且除非有嚴重的心臓症狀，否則並不建議開刀，(5)在次發性腫瘤中化學治療仍然是治療上的首選，除非有血流阻塞的現象。 |
| 英文摘要 | Cardiac tumors in infants and children are extremely rare. Their clinical manifestations vary widely from asymptomatic presentations to life-threatening cardiac events. Improvements in diagnostic techniques, such as those offered by echocardiography, have made early detection of cardiac masses possible, with or without the presence of clinical symptoms. Fifteen pediatric cases of cardiac tumor were diagnosed at our institution between July 1989 and July 2002 (male-female ratio, 10:5; age range, one day to nine years). Eleven of the cases involved primary cardiac tumors [rhabdomyoma (n=10) and fibroma (n=1)]. Ninety percent of the rhabdomyomas (9/10) were associated with tuberous sclerosis. Four of the fifteen cases were secondary metastatic tumors [hepatoblastoma (n=2), hepatoma (n=1) and rhabdomyosarcoma (n=1)]. Clinical manifestations of the cardiac tumors included shortness of breath (n=5), seizure (n=4), cardiac murmur (n=6), and cyanosis (n=3). Surgery was performed for three of]] patients with primary cardiac tumor (27%) due to severe obstruction of flow (n=2) and other cardiac defects (n=1). The primary cardiac tumor spontaneously regressed in five of the tuberous sclerosis patients. All four of the patients with secondary cardiac tumors continued to receive chemotherapy, and only one of them subsequently experienced regression. Based on our experiences, we conclude that: 1) rhabdomyoma is the most common primary cardiac tumor in children; 2) most pediatric tumors are associated with tuberous sclerosis; 3) clinical presentation is determined by the tumor size and number of tumors, and whether expansion of the malignancy has resulted in cardiac blood-flow obstruction; 4) there is a strong possibility of regression of the primary cardiac tumor, with surgery recommended only when cardiac symptoms are severe; and, 5) unless there is a significant obstruction of blood flow, chemotherapy is still the treatment of choice for secondary cardiac tumors. |
本系統中英文摘要資訊取自各篇刊載內容。