Intraatrial Recurrence of Small Cell Lung Cancer Mimicking Superior Vena Cava Syndrome: A Case Report

小細胞肺癌心房內復發疑上腔靜脈症候群：病例報告

楊宗憲(Tsuan-Shien Yang) ； 朱國安(Kuo-An Chu) ； 林旻希(Min-Hsi Lin) ； 王鴻昌(Hong-Chung Wang) ； 盧朝勇(Jau-Yeong Lu)

《胸腔醫學》 17卷4期 (2002/12) Pp. 420-424

摘要

一位經化學治療反應良好的小細胞肺癌病人，在常規追蹤中臨床上表現出像臉脹、上肢腫等疑似上腔靜脈症候群，經電腦斷層發現是心房內腫塊，並經進一步的核磁共振證實是肺癌轉移至左右心房。病人經完整的高放射線劑量治療，除在臨床上表現改善外，經追蹤的電腦斷層檢查發現腫塊明顯的消失。雖上腔靜脈症候群是小細胞肺癌常見的併發症，但在我們的病例上，卻可能是罕見的左右心房轉移造成的臨床表現。對於心內腔室的腫瘤和血塊的鑑別診斷，加顯影的核磁共振是非侵犯性的重要診斷工具。此病例對放射線治療的良好反應，也許可作為轉移性心內腫瘤的另一選擇性治療。

關鍵字

心房轉移 ； 核磁共振 ； 小細胞肺癌 ； 上腔靜脈症候群 ； 放射線治療

並列摘要

We present herein a case of small cell lung cancer exhibiting intracardiac metastases with a clinical appearance of superior vena cava obstruction which occurred six months after complete chemotherapy. This condition was suspected with a computed tomography of the chest, and was then confirmed by subsequent magnetic resonance imaging of the thorax. After local radiotherapy, the patient’s clinical symptoms improved, and a significant diminishing of intraatrial mass was demonstrated by follow-up computed tomography of the chest. Although superior vena cava syndrome is a common complication of small cell lung cancer, our case may have resulted from an intracardiac invasion, which is rarely seen clinically. Enhanced magnetic resonance imaging is an important non-invasive diagnostic tool used to differentiate between a thrombus and an intracardiac tumor. The radiotherapy which showed success in this case may be an effective alternative management for the intracardiac metastasis of small cell lung cancer.

並列關鍵字

atrial metastasis ； magnetic resonance imaging ； small cell lung cancer ； superiorvena cava syndrome ； radiotherapy