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題名 | Superior Vena Cava Syndrome Caused by Right Atrial Carcinosarcoma in Emergency Department: A Case Report and Literature Review=延遲診斷由右心房癌肉瘤所引起的上腔靜脈症候群:急診室個案報告 |
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作者 | 李國新; 孫灼均; 蔡易廷; | 書刊名 | 中華民國急救加護醫學會雜誌 |
卷期 | 23:2 2012.06[民101.06] |
頁次 | 頁71-76 |
分類號 | 415.385 |
關鍵詞 | 上腔靜脈症候群; 心臟癌肉瘤; Superior vena cava syndrome; Cardiac carcinosarcoma; |
語文 | 英文(English) |
中文摘要 | 上腔靜脈症候群的臨床表現通常是一群非特異性的症狀其典型表現像臉部頸部紅腫,呼吸喘及咳嗽都是急診室裡常見的主訴。上腔靜脈症候群症狀可能都持續一段時間且需要理學檢查和詳細的病史來與其他疾病作鑑別診斷。我們報告一個由右心房癌肉瘤引起上腔靜脈症侯群的病例在急診的臨床表現類似過敏反應,一個月後才確定診斷。儘管積極的治療病人最終半年後病人還是死於遠處腦部轉移。像這種懷疑上腔靜脈症候群的情形,胸部 X光和胸部顯影電腦段層應及早於急診室中安排作為鑑別診斷的工具是有價值的。 |
英文摘要 | Superior vena cava syndrome, which comprises a group of nonspecific signs and symptoms caused by obstruction of the superior vena cava (SVC), is usually a complication of SVC compression by pulmonaryor mediastinal tumors. Usual manifestations including shortness of breath, dyspnea, headache, and facial edema occur only after days to weeks after the beginning of SVC obstruction. Although a detailed medicalhistory and physical examination may shed light on the diagnosis, imaging studies are usually required for establishing the diagnosis and pinpointing the causes. Herein, we report a case of facial edema resultingfrom obstruction of superior vena cava caused by right atrial carcinosarcoma with initial presentation mimicking anaphylaxis in the emergency department. Final diagnosis was made one month later afterdisease progression. The patient died of distant brain metastasis six months later despite aggressive treatment. For early diagnosis, emergency physician should have a high level of suspicion for non-specificsymptoms hinting the diagnosis. Chest x-ray and contrast-enhanced chest computed tomography should be considered for differential diagnosis. |
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