Why the study?
Does combined urgent cardiac operation and CHOP-R chemotherapy improve survival in a patient with primary cardiac malignant lymphoma?
Does combined urgent cardiac operation and CHOP-R chemotherapy improve survival in a patient with primary cardiac malignant lymphoma?
Combined urgent surgical resection and CHOP-R chemotherapy can be an effective treatment strategy for primary cardiac malignant lymphoma presenting with right heart failure.
Hypothesis-generating for combined resection and CHOP-R in primary cardiac lymphoma with right heart failure; larger studies needed before broader adoption.
A 56-year-old man, suffering from rapidly worsening general fatigue, dyspnea on exercise and epigastralgia, was referred for evaluation and treatment of a cardiac tumor. Transthoracic echocardiography showed a 6-cm large mass occupying both the right ventricle and atrium. Gallium scintigraphy showed high uptake in the tumor site. Lymphoma was highly suggested. Urgent operation was performed and as much tumor and thrombus were removed as possible. The postoperative course was good, with cessation of right heart failure. Pathological examination suggested malignant lymphoma, diffuse large B-cell type. The patient was treated with rituximab, cyclophosphamide, Adriamycin, vincristine, and prednisone (CHOP-R) postoperatively and has survived for 2 years without signs of recurrence.
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Fujita et al. (2009) studied this question.
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