前縦隔に有茎性発育し，急速に再発した限局型線維性胸膜中皮腫の１例

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  • Solitary fibrous mesothelioma of the pleura which originated in the anterior mediastinum with a peduncle and recurred rapidly at the same site; a case report.

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The patient was a 55-year-old female who visited a local physician because of cough and dyspnea on exertion. A chest radiograph revealed an abnormal shadow, and the patient was referred to our hospital for further evaluation. Diagnostic imaging disclosed an anterior mediastinal tumor. A needle biopsy was performed, and a diagnosis of fibrous mesothelioma was made. A routine chest radiograph taken 2 years earlier revealed a 3-cm tumor in the right upper mediastinum. On April 22, 1992, thoracotomy was performed via median sternotomy. The tumor was located in the right anterior mediastinum. Adhesions between the tumor and the right mediastinal pleura, as well as the pericardium, were noted. The tumor was excised with adhesiotomy from the mediastinal pleura and the pericardium. The tumor weighed 545 grams and measured 12.8 × 10.0 × 7.3 cm. A defect in the tumor capsule was present at the site of the tumor's adhesion to the pericardium. A peduncle was seen near the right brachiocephalic vein. Tumor recurrence was detected at the original site 3 months after surgery, and the patient underwent reoperation on July 15. The tumor had already invaded the pericardial cavity. and 4 free tumor nodules were found at the site. The pericardium was partially resected with the tumor. The recurrent tumor weighed 160 grams and measured 9.0 ×7.0 × 5.0cm. Three months after the second operation, the patient died of cardiac tamponade. The recurrent tumor formed a mass within the pericardium.

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