血性心嚢液を伴い, FDG-PETで高集積を呈した前縦隔デスモイド腫瘍の1例  [in Japanese] Anterior mediastinal desmoid tumor  [in Japanese]

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Author(s)

    • 橋詰 寿律 HASHIZUME Toshinori
    • 独立行政法人国立院機構茨城東病院 外科 Department of General Thoracic Surgery, National Hospital Organization Ibarakihigashi National Hospital
    • 山本 純 YAMAMOTO Jun
    • 独立行政法人国立院機構茨城東病院 外科 Department of General Thoracic Surgery, National Hospital Organization Ibarakihigashi National Hospital
    • 島内 正起 SHIMANOUCHI Masaoki
    • 独立行政法人国立院機構茨城東病院 外科 Department of General Thoracic Surgery, National Hospital Organization Ibarakihigashi National Hospital
    • 濱本 篤 HAMAMOTO Atsushi
    • 独立行政法人国立院機構茨城東病院 外科 Department of General Thoracic Surgery, National Hospital Organization Ibarakihigashi National Hospital
    • 水渡 哲史 SUITO Tetsushi
    • 独立行政法人国立院機構茨城東病院 外科 Department of General Thoracic Surgery, National Hospital Organization Ibarakihigashi National Hospital
    • 深井 志摩夫 FUKAI Shimao
    • 独立行政法人国立院機構茨城東病院 外科 Department of General Thoracic Surgery, National Hospital Organization Ibarakihigashi National Hospital

Abstract

症例は53歳男性.胸痛を主訴に来院.胸部単純X線写真,CTおよびMRIで前縦隔に充実性の腫瘤を認めた.FDG-PET検査で高集積を認め前縦隔腫瘍と診断し,腫瘍および心膜,両側縦隔胸膜合併切除を行った.腫瘍は心膜を貫き,心嚢内に露出していた.血性心嚢液を100ml認めたが,細胞診はclass IIであった.病理学的にデスモイド腫瘍と診断された.術後縦隔に放射線を50Gy照射したにもかかわらず外来通院中に局所再発を来たした.その後,タモキシフェンの投与を行ったが効果なく術後2年4ヵ月で腫瘍死した.

Desmoid tumors rarely arise from the anterior mediastinum. We report such a case. A 53-year-old man with a 5-month history of anterior chest pain was admitted to our hospital. Computed tomography and magnetic resonance imaging showed an abnormal shadow in the anterior mediastinum. The tumor showed marked uptake on FDG positron emission tomography. We performed thoracotomy with a median sternotomy. The tumor involved the bilateral mediastinal pleura and pericardium. Bloody pericardial effusion was recognized. We excised the tumor with bilateral mediastinal pleura and pericardium. The pericardium was reconstructed with a Gore-Tex<SUP>®</SUP> soft tissue patch. The histological diagnosis was a desmoid tumor, 9.0×8.8×4.5 cm, and the cytology of the bloody pericardial effusion was class II. Additional therapy was performed with 50 Gy of irradiation for the mediastinum. About 1 year and 9 months later, local recurrence occurred in the upper mediastinum. He received hormonal therapy, but died 2 years and 4 months after the operation.

Journal

  • The Journal of the Japanese Association for Chest Surgery

    The Journal of the Japanese Association for Chest Surgery 24(6), 901-905, 2010-09-15

    The Japanese Association for Chest Surgery

References:  19

Codes

  • NII Article ID (NAID)
    10026639569
  • NII NACSIS-CAT ID (NCID)
    AN10467885
  • Text Lang
    JPN
  • Article Type
    NOT
  • ISSN
    09190945
  • Data Source
    CJP  J-STAGE 
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