Cardiac Tamponade as the Initial Presentation of Thymic Carcinoma-A Case Report

胸腺癌以心包膜填塞為最初表徵－一病例報告

原博榮(Po-Jung Yuan) ； 黃維健(Wai-Kin Wong)

《Acta Cardiologica Sinica》 22卷2期 (2006/06) Pp. 112-116

摘要

胸腺癌是前縱隔腔極為少見的腫瘤，好發於四十歲以上之成人。一般而言，它會先有一段長時間的無症狀期。最常見的表現是無意間在胸部x光片發現腫塊。有症狀的病人常抱怨胸痛、咳嗽以及其他上呼吸道的症狀。心包膜積水偶而可見於此類病人，但心包膜填塞就非常少見。只有零星個案被報導。我們在此報導一個六十五歲女性胸腺癌案例：病人有暈眩的產生，其原因為心包膜填塞。緊急心包膜抽水救回此病人。細針病理切片証實為分化不好的上皮細胞胸腺癌。電腦斷層証實腫瘤擴散至胸壁、心包膜、主動脈、肺動脈以及上腔靜脈。

關鍵字

心包膜填塞 ； 胸腺癌

並列摘要

Thymic carcinoma is a rare tumor in the anterior mediastinum, which is often seen in adults over 40 years old. Typically, it is asymptomatic for a prolonged period of time. An incidental finding of a mass on a chest x-ray film is the most common presentation. Symptomatic patients often complain of chest pain, cough or other upper respiratory symptoms. Pericardial effusion may be present occasionally, but cardiac tamponade is rarely seen. There are only scattered reports of thymic carcinoma presenting with cardiac tamponade. We report a 65-year-old woman with thymic carcinoma who had an episode of near-syncope due to cardiac tamponade. Emergent pericardiocentesis terminated the life-threatening condition. Fine needle biopsy showed a poorly differentiated epidermoid thymic carcinoma. Computed tomography of the chest also proved that tumor extended to the chest wall, pericardium, aorta, pulmonary arteries and superior vena cava.

並列關鍵字

Cardiac tamponade ； Thymic carcinoma