胸腔鏡補助下に摘出した縦隔脂肪腫の１例

DOI 被引用文献2件 参考文献6件

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  • A case of video-assisted resection of mediastinal lipoma.

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We report a case of anterior mediastinal lipoma resected through a minimal thoracotomy under thoracoscopic assistance. A 53-year-old woman without symptoms was admitted for evaluation of an anterior mediastinal tumor on chest roentgenogram.<BR>A routine chest roentgenogram demonstrated an abnormal mass shadow at the right cardiophrenic angle and the mass increased in size after 1 year observation from 4 cm to 5 cm in diameter. Computed tomogram showed a homogeneous mass of fat density on the right diaphragm and adjoining the heart and the right anterior chest wall. Magnetic resonance image revealed a well-demarcated mediastinal tumor with a fat signal intensity on both T1-weighted and T2-weighted images. The first trocar was placed at the eighth intercostal space along the midaxillary line. Thoracoscopic view showed a yellowish and round tumor bordering on pericardium, diaphragm, and anterior chest wall. Minimal thoracotomy was made through the fifth intercostal space with 5 cm skin incision along the lower mammary line. The tumor was soft and encapsulized without invasion to adjacent organs and was resected easily with assisted view of thoracoscope.<BR>The tumor was histologically diagnosed as a mature lipoma. The diagnosis of mediasinal lipoma and its differentiation from malignant lesions is important for treatment and prognosis. Both computed tomogram and magnetic resonance image are useful in differentiating mediastinal lipoma, but they are not accurate in differentiating liposarcomas from benign lipomas. Thoracoscope assisted minimal thoracotomy procedure is less invasive than conventional procedure.

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