A MULTIDISCIPLINARY APPROACH TO THE TREATMENT OF MALIGNANT HEART TUMOR
https://doi.org/10.17238/issn2072-3180.2020.4.88-91
Abstract
Introduction: Paragangliomas are rare neuroendocrine neoplasms with a frequency of 0.001–0.01% in the general population, which arise from the adrenal medulla and extrarenal autonomic paraganglia, respectively. Paraganliomas of the heart are extremely rare primary neuroendocrine tumors of the heart, accounting for less than 1% of all cardiac neoplasms. Their location is clinically important as they can interfere with heart function. For large paragangliomas of the heart with myocardial invasion, the need for heart reconstruction or transplantation may potentially arise.
Materials and methods: the presented experience, due to clinical multifactoriality, included several options for staged treatment.
Discussion: in our case, taking into account the secretion of catecholamines, sick sinus syndrome, a high risk of bleeding, and tumor fragmentation, the first stage was to achieve the regression of the tumor by means of embolization with afferent spirals feeding the heart tumor. However, due to several sources of blood supply to the formation, this method of treatment did not lead to the desired effect. In this regard, the tactics of open surgical intervention was chosen to remove the formation with the reconstruction of the heart chambers. According to the data of postoperative biopsy, data on paraganglioma were obtained.
Conclusion: This experience shows the importance of a multidisciplinary and personalized approach to treating patients in a multidisciplinary hospital.
About the Authors
D. V. ShumakovRussian Federation
Shumakov Dmitry Valerievich — MD, professor, corresponding member RAS, Head of the Department of Cardiac and Vascular Surgery
Schepkina str., 61/2, Moscow, 129110
V. A. Dudakov
Russian Federation
Dudakov Vladimir Alexandrovich — PhD in Medicine, Head of Department of the Cardiac Surgery
Schepkina str., 61/2, Moscow, 129110
D. I. Zybin
Russian Federation
Zybin Dmitry Igorevich – PhD in Medicine, Head of Department of the Cardiac Surgery
Schepkina str., 61/2, Moscow, 129110
A. V. Vashchenko
Russian Federation
Vashchenko Anton Vasilievich – PhD in Medicine, Head of Department of the Angiography
Schepkina str., 61/2, Moscow, 129110
B. B. Gegenava
Russian Federation
Gegenava Boris Borisovich – PhD in Medicine, Leading researcher, Head of Department of the Endovascular Surgery
Schepkina str., 61/2, Moscow, 129110
A. A. Tereshina
Russian Federation
Tereshina Anna Alexandrovna — Anesthesiologist of the Department of Anesthesiology and Resuscitation
Schepkina str., 61/2, Moscow, 129110
B. V. Ivashkin
Russian Federation
Ivashkin Bogdan Vasilievich — Endovascular surgeon of the Department of Angiography
Schepkina str., 61/2, Moscow, 129110
S. A. Kurnosov
Russian Federation
Kurnosov Sergey Alekseevich — Junior Researcher of the Department of Endovascular Surgery
Schepkina str., 61/2, Moscow, 129110
M. S. Kapranov
Russian Federation
Kapranov Maxim Sergeevich — Researcher of the Department of Endovascular Surgery
Schepkina str., 61/2, Moscow, 129110
M. A. Popov
Russian Federation
Popov Mikhail Alexandrovich Researcher of the Department of Cardiac Surgery
Schepkina str., 61/2, Moscow, 129110
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Review
For citations:
Shumakov D.V., Dudakov V.A., Zybin D.I., Vashchenko A.V., Gegenava B.B., Tereshina A.A., Ivashkin B.V., Kurnosov S.A., Kapranov M.S., Popov M.A. A MULTIDISCIPLINARY APPROACH TO THE TREATMENT OF MALIGNANT HEART TUMOR. Moscow Surgical Journal. 2020;(4):88-94. (In Russ.) https://doi.org/10.17238/issn2072-3180.2020.4.88-91