胸腺嚢腫から発生した胸腺癌の1手術例 [in Japanese] A SURGICAL CASE OF THYMIC CARCINOMA ARISEN IN A THYMIC CYST [in Japanese]
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病例は62歳,男性.脳梗塞の診断で入院,加療中に縦隔影拡大を認め当科紹介となる.画像診断から胸腺嚢腫が考えられ, informed consent後に胸骨正中切開による手術を施行したが,嚢胞壁も厚く充実性な部分も触知したため胸腺腫合併も考慮して拡大胸腺胸腺腫全摘術を施行した.術後病理で胸腺嚢胞壁より胸腺癌が発生したと診断され,正岡の臨床病期分類でII期と判断した.術後経過は良好でシスプラチンを中心とした化学療法と放射線療法を追加施行した.本来,胸腺嚢腫は良性疾患であるが本例のごとく胸腺嚢腫壁から胸腺癌が発生しうる可能性があり,胸腺嚢腫でも積極的な手術療法が必要と考えられた.
A 62-year-old male was admitted to the hospital because of cerebral infarction, and an enlarged mediastinal shadow was found during the therapy. Imaging studies suggested a diagnosis of a thymic cyst, and extended thymectomy and restriction of the mediastinal tumor were performed after obtaining informed consent from the patient. Histopathological examination, however, revealed thymic carcinoma in the Masaoka's clinical stage II that had developed in the cyst wall. Postoperatively, the patient was treated with adjunctive cisplatin-based chemotherapy and radiotherapy. He is currently being followed in the outpatient clinic.<br> Although thymic cyst is primarily a benign disorder, thymic carcinoma may arise in the wall of thymic cysts, as in the present case. Thus, aggressive surgical intervention should be considered even for thymic systs.
- The journal of the Japanese Practical Surgeon Society
The journal of the Japanese Practical Surgeon Society 67(6), 1257-1260, 2006-06-25
Japan Surgical Association